Provider Demographics
NPI:1174974554
Name:COLLINS, JAMIE (PHARM D)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:COONCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10816 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10816 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 301
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4354
Practice Address - Country:US
Practice Address - Phone:501-219-1881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD13659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist