Collin Amos
Individual provider Active NPI Pharmacist · Fayetteville, TN
NPI 1194336818 · NPPES record last updated Aug 14, 2020
Key facts
- NPI
- 1194336818
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 43170 (TN)
- Practice address
- 1000 Huntsville Hwy
Fayetteville, TN 37334 - Phone
- (931) 433-5569
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21331 | AL | MD | Pharmacist |
| 43170 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21331 | AL | |
| Pharmacist | 183500000X | 43170 | TN | Yes |
Addresses
Primary practice location
1000 Huntsville Hwy
Fayetteville, TN 37334
Mailing address
1000 Huntsville Hwy
Fayetteville, TN 37334
Other providers in Fayetteville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.