1639113913 NPI number — SNOOK CHIROPRACTIC AND NUTRITION CENTER, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639113913 NPI number — SNOOK CHIROPRACTIC AND NUTRITION CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SNOOK CHIROPRACTIC AND NUTRITION CENTER, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639113913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 145
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BART
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17503-0145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-786-1777
Provider Business Mailing Address Fax Number:
717-786-5193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 LANCASTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHRISTIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17509-9504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-786-1777
Provider Business Practice Location Address Fax Number:
717-786-5193
Provider Enumeration Date:
06/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SNOOK
Authorized Official First Name:
RICKEY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
717-786-1777

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  DC002334L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02638700 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1031375 . This is a "ASHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 081786 . This is a "MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 183544SOC . This is a "MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: SN1618842 . This is a "HIGHMARK BLUE SHEILD GROU" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".