Healthcare Provider Details

I. General information

NPI: 1821357344
Provider Name (Legal Business Name): DAVID COLLINS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3388 BRENTWOOD DR
BATON ROUGE LA
70809-1700
US

IV. Provider business mailing address

PO BOX 80138
SHREVEPORT LA
71148-0138
US

V. Phone/Fax

Practice location:
  • Phone: 318-616-5039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number00
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number00
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number00
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: