Provider Demographics
NPI:1649017294
Name:COLLABRATIVE MEDICAL SOLUTIONS
Entity type:Organization
Organization Name:COLLABRATIVE MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-521-2097
Mailing Address - Street 1:124 FRASIER FIR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9372
Mailing Address - Country:US
Mailing Address - Phone:803-200-2541
Mailing Address - Fax:
Practice Address - Street 1:820 E PARK AVE STE B
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2600
Practice Address - Country:US
Practice Address - Phone:803-200-8541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health