Healthcare Provider Details

I. General information

NPI: 1023620838
Provider Name (Legal Business Name): BOND DRUG STORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
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 827 310 US 50 WEST
TIPTON MO
65081-0827
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

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