MEDICARE: MR. TIMOTHY MICHAEL BOND RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	4740	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275616450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY MICHAEL BOND RPH

Provider Business Mailing Address
First Line	:	1102 51ST ST
Second Line	:
City	:	VIENNA
State	:	WV
Zip	:	26105-3172
Country	:	US
Telephone Number	:	304-295-8381
Fax Number	:	304-863-8813

Provider Business Practice Location Address
First Line	:	1 BONDS PLZ
Second Line	:
City	:	WASHINGTON
State	:	WV
Zip	:	26181-9762
Country	:	US
Telephone Number	:	304-863-3051
Fax Number	:	304-863-8813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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