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General NPI Number Information
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NPI Number | 1457169948
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Entity Type | Organization
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Legal Business Name | COLLINS RX LLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2160 N COLLINS ST # 120
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City | ARLINGTON
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State | TX
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Zip | 76011-2877
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Country | US
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Telephone | 469-307-6162
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Fax | 817-720-5553
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Provider Business Mailing Address
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Address Line | 2160 N COLLINS ST # 120
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City | ARLINGTON
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State | TX
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Zip | 76011-2877
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Country | US
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Telephone | 469-307-6162
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Fax | 817-720-5553
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MAHATHI KANKANALA
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Credential |
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Telephone | 817-720-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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