Provider Demographics
NPI:1255520631
Name:COLLINS AND COLLINS INTERIOR
Entity type:Organization
Organization Name:COLLINS AND COLLINS INTERIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-309-9027
Mailing Address - Street 1:1202 WILKES WAY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5709
Mailing Address - Country:US
Mailing Address - Phone:404-309-9027
Mailing Address - Fax:770-792-9019
Practice Address - Street 1:1202 WILKES WAY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5709
Practice Address - Country:US
Practice Address - Phone:404-309-9027
Practice Address - Fax:770-792-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA596312332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies