1306484449 NPI number — DR. ARLENE PENNY PRICE SNYDER PHARMD

Table of content: DR. ARLENE PENNY PRICE SNYDER PHARMD (NPI 1306484449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306484449 NPI number — DR. ARLENE PENNY PRICE SNYDER PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRICE SNYDER
Provider First Name:
ARLENE
Provider Middle Name:
PENNY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PRICE SNYDER
Provider Other First Name:
ARLENE
Provider Other Middle Name:
PENNY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1306484449
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9795 VIA VERGA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE WORTH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33467-6163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-562-3880
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 S SUNRISE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-7663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-322-2784
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  32413 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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