Healthcare Provider Details

I. General information

NPI: 1992721856
Provider Name (Legal Business Name): BUNNY'S PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N MAIN AVE
SIDNEY OH
45365-2731
US

IV. Provider business mailing address

112 N MAIN AVE
SIDNEY OH
45365-2731
US

V. Phone/Fax

Practice location:
  • Phone: 937-492-4550
  • Fax: 937-497-7986
Mailing address:
  • Phone: 937-492-4550
  • Fax: 937-497-7986

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRTP020100250
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREGORY BONNORONT
Title or Position: PRESIDENT
Credential: RPH
Phone: 737-472-4550