Provider Demographics
NPI:1174818082
Name:SNIDER, KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 US HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-4211
Mailing Address - Country:US
Mailing Address - Phone:904-824-7127
Mailing Address - Fax:904-824-7127
Practice Address - Street 1:1440 US HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4211
Practice Address - Country:US
Practice Address - Phone:904-824-7127
Practice Address - Fax:904-824-7127
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist