MEDICARE: BOND'S DRUG STORE

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	333600000X	Pharmacy	SP0550345	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	:	1841373933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOND'S DRUG STORE

Provider Business Mailing Address
First Line	:	1649 HARRIS HWY
Second Line	:
City	:	WASHINGTON
State	:	WV
Zip	:	26181-3599
Country	:	US
Telephone Number	:	304-863-3051
Fax Number	:	304-863-8813

Provider Business Practice Location Address
First Line	:	1649 HARRIS HWY
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	:	PRESIDENT
Name	:	MR. TIMOTHY MICHAEL BOND
Credential	:	RPH
Telephone Number	:	304-863-3051

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	01/28/2013

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1275616450 — MR. TIMOTHY MICHAEL BOND RPH
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Practice Location Address:

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1942538418 — KATRINA MARGARET VANHORN CYT
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1538440946 — KAREN MASON PHARM D
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Directions to “BOND'S DRUG STORE ” Practice Location

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