Provider Demographics
NPI:1205043379
Name:SNIDER, MELISSA JEANNETTE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEANNETTE
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 1:2393 OAKTHORPE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8111
Mailing Address - Country:US
Mailing Address - Phone:614-319-4321
Mailing Address - Fax:
Practice Address - Street 1:452 W. 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-0649
Practice Address - Fax:614-293-2867
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist