MEDICARE: MR. DENNIS R. BOND R.PH.

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	028078	MO

General Provider Information

NPI Number	:	1396735817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DENNIS R. BOND R.PH.

Provider Business Mailing Address
First Line	:	14 GOLF COURSE RD
Second Line	:
City	:	ELDON
State	:	MO
Zip	:	65026-4613
Country	:	US
Telephone Number	:	573-280-2329
Fax Number	:	573-392-4425

Provider Business Practice Location Address
First Line	:	101 S MAPLE ST
Second Line	:
City	:	ELDON
State	:	MO
Zip	:	65026-1850
Country	:	US
Telephone Number	:	573-392-4588
Fax Number	:	573-392-4425

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	05/12/2008

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Directions to “ MR. DENNIS R. BOND R.PH.” Practice Location

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