Provider Demographics
NPI:1225356603
Name:COLLINS, WILLIAM BRENT SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRENT
Last Name:COLLINS
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 STERLING RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MA
Mailing Address - Zip Code:01541-1201
Mailing Address - Country:US
Mailing Address - Phone:508-561-9522
Mailing Address - Fax:
Practice Address - Street 1:197 STERLING RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MA
Practice Address - Zip Code:01541-1201
Practice Address - Country:US
Practice Address - Phone:508-561-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist