Provider Demographics
NPI:1518345339
Name:COLLINS, ASHLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04758-1019
Mailing Address - Country:US
Mailing Address - Phone:207-425-4431
Mailing Address - Fax:207-425-2400
Practice Address - Street 1:106 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:ME
Practice Address - Zip Code:04758-1019
Practice Address - Country:US
Practice Address - Phone:207-425-4431
Practice Address - Fax:207-425-2400
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEADV45306183500000X
MEPR5541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist