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General NPI Number Information
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NPI Number | 1366563819
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Entity Type | Organization
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Legal Business Name | CA COLLINS ENTERPRISES INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 2544 MCLEOD DR N STE 2
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City | SAGINAW
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State | MI
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Zip | 48604-2854
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Country | US
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Telephone | 989-791-1691
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Fax | 989-791-4603
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Provider Business Mailing Address
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Address Line | 2544 MCLEOD DR N STE 2
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City | SAGINAW
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State | MI
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Zip | 48604-2854
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Country | US
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Telephone | 989-791-1691
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Fax | 989-791-4603
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Authorized Official
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Title or Position | OFC MNGR
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Name | STACY HAMAN
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Credential | CPHT
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Telephone | 989-791-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301007805
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License Number State | MI
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