Mandy Jo Collins, PHARMD

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Madison, IN

NPI 1982243622 · NPPES record last updated Dec 28, 2019

Key facts

NPI
1982243622
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
26020138A (IN)
Practice address
525 E Clifty Dr
Madison, IN 47250-1672
Phone
(812) 273-3343
NPI assigned
Dec 28, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26020138AINMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past
since Jan 5, 2020
Accepting new patients
Kroger Limited Partnership I Past
since Jan 5, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 26020138A IN Yes

Addresses

Primary practice location

525 E Clifty Dr
Madison, IN 47250-1672

Mailing address

525 E Clifty Dr
Madison, IN 47250-1672
Phone (812) 273-3343

Other providers in Madison, IN

All providers in Madison, IN · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana

Sources for this page

Verify at the official NPI Registry.