Provider Demographics
NPI:1114235397
Name:COLLINS, JANICE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1322
Mailing Address - Country:US
Mailing Address - Phone:207-834-5444
Mailing Address - Fax:207-834-2897
Practice Address - Street 1:84 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1322
Practice Address - Country:US
Practice Address - Phone:207-834-5444
Practice Address - Fax:207-834-2897
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist