MEDICARE: THOMAS COLLINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	039398	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265610315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS COLLINS

Provider Business Mailing Address
First Line	:	1829 CHILI AVENUE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-3424
Country	:	US
Telephone Number	:	585-957-9946
Fax Number	:	585-957-9947

Provider Business Practice Location Address
First Line	:	1829 CHILI AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-3237
Country	:	US
Telephone Number	:	585-957-9946
Fax Number	:	585-957-9947

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	11/06/2022

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Directions to “ THOMAS COLLINS ” Practice Location

Language	Start Address	Practice Location

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