Provider Demographics
NPI:1679309918
Name:SNYDER, RENEE KATHLEEN (RPH)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:KATHLEEN
Last Name:SNYDER
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 1:600 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:SMETHPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16749-1311
Mailing Address - Country:US
Mailing Address - Phone:814-598-0750
Mailing Address - Fax:
Practice Address - Street 1:600 E GREEN ST
Practice Address - Street 2:
Practice Address - City:SMETHPORT
Practice Address - State:PA
Practice Address - Zip Code:16749-1311
Practice Address - Country:US
Practice Address - Phone:814-598-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042002L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty