Collective Services, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

22616 Issued in TX

Legal business name

COLLECTIVE SERVICES, INC

Practice address

2435 Gravel Dr
Fort Worth, TX 76118-6937

Phone

(817) 595-1556

Fax

(817) 595-1536

NPI assigned

Aug 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ayesha Siddiqi

Title

Accounts Coordinator

Phone

(817) 784-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164423513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TECH CENTRE PKWY",
            "address_2": "SUITE # 110",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760144405",
            "telephone_number": "817-784-2400",
            "fax_number": "817-676-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 GRAVEL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761186937",
            "telephone_number": "817-595-1556",
            "fax_number": "817-595-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "ACCOUNTS COORDINATOR",
        "authorized_official_telephone_number": "817-784-2400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "22616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "4537962",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.