Provider Demographics
NPI:1417624610
Name:SNEMIS, DOMINIC VINCENZO DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:DOMINIC
Middle Name:VINCENZO DAVID
Last Name:SNEMIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1205
Mailing Address - Country:US
Mailing Address - Phone:219-242-9020
Mailing Address - Fax:
Practice Address - Street 1:360 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1205
Practice Address - Country:US
Practice Address - Phone:720-258-8203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0023652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist