Healthcare Provider Details

I. General information

NPI: 1801875950
Provider Name (Legal Business Name): BANDY'S PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 W HOBSONWAY
BLYTHE CA
92225
US

IV. Provider business mailing address

707 W HOBSONWAY
BLYTHE CA
92225-1514
US

V. Phone/Fax

Practice location:
  • Phone: 760-922-5165
  • Fax: 760-922-0058
Mailing address:
  • Phone: 760-922-5165
  • Fax: 760-922-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number56037
License Number StateCA

VIII. Authorized Official

Name: MR. AMIT HASOLKAR
Title or Position: CFO/OWNER
Credential: PHARM.D.
Phone: 760-922-5165