Provider Demographics
NPI:1275884488
Name:SNYDER, SCOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:SNYDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 NE HALBROOK LN
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9716
Mailing Address - Country:US
Mailing Address - Phone:515-289-1964
Mailing Address - Fax:
Practice Address - Street 1:6902 NE HALBROOK LN
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9716
Practice Address - Country:US
Practice Address - Phone:515-289-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist