Provider Demographics
NPI:1447462791
Name:COLLINS, CAROL J (RPH)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8733 N LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-4509
Mailing Address - Country:US
Mailing Address - Phone:850-233-2732
Mailing Address - Fax:850-233-2732
Practice Address - Street 1:2533 THOMAS DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-6252
Practice Address - Country:US
Practice Address - Phone:850-235-3200
Practice Address - Fax:850-234-2341
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist