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General NPI Number Information
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NPI Number | 1285819953
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD COLLINS R.PH.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 341 STATE ROUTE 104 WALMART PHARMACY
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City | OSWEGO
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State | NY
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Zip | 13126-2911
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Country | US
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Telephone | 315-342-2212
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Fax | 315-342-2225
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Provider Business Mailing Address
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Address Line | 341 STATE ROUTE 104 EAST WALMART PHARMACY
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City | OSWEGO
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State | NY
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Zip | 13126
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Country | US
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Telephone | 315-342-2212
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Fax | 315-342-2225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 31563
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License Number State | NY
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