Healthcare Provider Details

I. General information

NPI: 1417749367
Provider Name (Legal Business Name): BOND DRUG STORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 US HIGHWAY 50 W
TIPTON MO
65081-8701
US

IV. Provider business mailing address

PO BOX 827
TIPTON MO
65081-0827
US

V. Phone/Fax

Practice location:
  • Phone: 660-433-6336
  • Fax: 660-433-6320
Mailing address:
  • Phone: 660-433-6336
  • Fax: 660-433-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN HARLOW HILLS
Title or Position: OWNER
Credential:
Phone: 573-216-1866