Healthcare Provider Details

I. General information

NPI: 1336243393
Provider Name (Legal Business Name): BOND PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 HIGHLAND COLONY PKWY STE 100
RIDGELAND MS
39157-6077
US

IV. Provider business mailing address

623 HIGHLAND COLONY PKWY STE 100
RIDGELAND MS
39157-6077
US

V. Phone/Fax

Practice location:
  • Phone: 601-988-1700
  • Fax: 601-988-1701
Mailing address:
  • Phone: 601-988-1700
  • Fax: 601-988-1701

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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberNP000010
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number04274/2.0
License Number StateMS

VIII. Authorized Official

Name: SIMON CASTELLANOS
Title or Position: CEO
Credential:
Phone: 601-988-1700