Healthcare Provider Details

I. General information

NPI: 1619277266
Provider Name (Legal Business Name): DEBORAH W COLLINS R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 NORTH ROXBORO ST.
DURHAM NC
27704
US

IV. Provider business mailing address

3737 NORTH ROXBORO STREET
DURHAM NC
27704
US

V. Phone/Fax

Practice location:
  • Phone: 919-471-4166
  • Fax:
Mailing address:
  • Phone: 919-471-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number08489
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: