Active NPI
Ed Snell, RPH
- Nutrition Support Pharmacist
- Pocatello, ID
National Provider Identifier
1104828870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Pharmacist
- License
- P4033
- Practice address
- 1015 E Young St
Pocatello, ID 83201-5282 - Phone
- (208) 232-0049
- Fax
- (208) 232-3963
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Pharmacist | 1835N1003X | P4033 | ID | Primary |
Addresses
Primary practice location
1015 E Young St
Pocatello, ID 83201-5282
Mailing address
1015 E Young St
Pocatello, ID 83201-5282
Phone (208) 232-0049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4033 | ID | MD | Nutrition Support Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104828870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 E YOUNG ST",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015282",
"telephone_number": "208-232-0049",
"fax_number": "208-232-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 E YOUNG ST",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832015282",
"telephone_number": "208-232-0049",
"fax_number": "208-232-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNELL",
"first_name": "ED",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "ID",
"license": "P4033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.