Provider Demographics
NPI:1831185164
Name:SNIDER, GEORGE
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:SNIDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7027 BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9171
Mailing Address - Country:US
Mailing Address - Phone:502-252-8242
Mailing Address - Fax:502-252-7556
Practice Address - Street 1:101 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:KY
Practice Address - Zip Code:40008-7142
Practice Address - Country:US
Practice Address - Phone:502-252-8468
Practice Address - Fax:502-252-7556
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7452OtherPHARMACIST LICENSE