Active NPI
Michael Edward Collins, R.PH.
- Pharmacist
- Oswego, NY
National Provider Identifier
1285819953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 31563
- Practice address
- 341 State Route 104
Walmart Pharmacy
Oswego, NY 13126-2911 - Phone
- (315) 342-2212
- Fax
- (315) 342-2225
- NPI assigned
- Dec 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 31563 | NY | Primary |
Addresses
Primary practice location
341 State Route 104
Walmart Pharmacy
Oswego, NY 13126-2911
Mailing address
341 State Route 104 East
Walmart Pharmacy
Oswego, NY 13126
Phone (315) 342-2212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00484368 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31563 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1285819953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 STATE ROUTE 104 EAST",
"address_2": "WALMART PHARMACY",
"city": "OSWEGO",
"state": "NY",
"postal_code": "13126",
"telephone_number": "315-342-2212",
"fax_number": "315-342-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "341 STATE ROUTE 104",
"address_2": "WALMART PHARMACY",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131262911",
"telephone_number": "315-342-2212",
"fax_number": "315-342-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "MICHAEL",
"middle_name": "EDWARD",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-31",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "31563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00484368",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.