Provider Demographics
NPI:1265641245
Name:COLLINS, MARGARET OLIVE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:OLIVE
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 1:306 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-1438
Mailing Address - Country:US
Mailing Address - Phone:850-567-9621
Mailing Address - Fax:
Practice Address - Street 1:112 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:FL
Practice Address - Zip Code:32333-1620
Practice Address - Country:US
Practice Address - Phone:850-539-8080
Practice Address - Fax:850-539-3050
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist