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General NPI Number Information
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NPI Number | 1255520631
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Entity Type | Organization
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Legal Business Name | COLLINS AND COLLINS INTERIOR
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1202 WILKES WAY SW
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City | MARIETTA
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State | GA
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Zip | 30064-5709
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Country | US
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Telephone | 404-309-9027
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Fax | 770-792-9019
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Provider Business Mailing Address
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Address Line | 1202 WILKES WAY SW
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City | MARIETTA
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State | GA
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Zip | 30064-5709
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Country | US
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Telephone | 404-309-9027
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Fax | 770-792-9019
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Authorized Official
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Title or Position | CEO
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Name | MR. ANDREW A. COLLINS
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Credential |
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Telephone | 404-309-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 596312
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License Number State | GA
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