Provider Demographics
NPI:1942705413
Name:COLLINS TRANSPORTATION
Entity Type:Organization
Organization Name:COLLINS TRANSPORTATION
Other - Org Name:COLLINS TRANSPORTATION LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-288-6291
Mailing Address - Street 1:404 SE CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5378
Mailing Address - Country:US
Mailing Address - Phone:386-288-6291
Mailing Address - Fax:386-243-8545
Practice Address - Street 1:317 4TH ST NW
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:FL
Practice Address - Zip Code:32052-5953
Practice Address - Country:US
Practice Address - Phone:386-288-6291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker