Provider Demographics
NPI:1851996714
Name:SNODGRASS, DENISE MICHELLE (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MICHELLE
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-8161
Mailing Address - Country:US
Mailing Address - Phone:215-630-0909
Mailing Address - Fax:
Practice Address - Street 1:201 MUNCY CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-5405
Practice Address - Country:US
Practice Address - Phone:570-546-8361
Practice Address - Fax:570-546-0792
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045680L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist