Provider Demographics
NPI:1609909878
Name:COLLINS, WILLIAM HARMON ANDREW (RPH, DPH, PD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARMON ANDREW
Last Name:COLLINS
Suffix:
Gender:M
Credentials:RPH, DPH, PD
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 2725
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305-2725
Mailing Address - Country:US
Mailing Address - Phone:912-437-4612
Mailing Address - Fax:904-277-1501
Practice Address - Street 1:1722 S 8TH ST
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-1903
Practice Address - Country:US
Practice Address - Phone:904-277-7835
Practice Address - Fax:904-277-1501
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS13214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist