MEDICARE: ARICA COLLINS RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	012948	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	012948	OTHER	KY	NATIONAL ASSOCIATION OF BOARDS OF PHARMACY

General Provider Information

NPI Number	:	1518439678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARICA COLLINS RPH

Provider Business Mailing Address
First Line	:	6828 OLD MONTICELLO RD
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-5758
Country	:	US
Telephone Number	:	606-219-3019
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E CUMBERLAND ST
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1206
Country	:	US
Telephone Number	:	606-387-6444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2018
Last Update Date	:	12/28/2018

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