Healthcare Provider Details

I. General information

NPI: 1164530630
Provider Name (Legal Business Name): BOND ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 POINT FOSDICK DR NW STE 120
GIG HARBOR WA
98335-1706
US

IV. Provider business mailing address

4700 POINT FOSDICK DR NW STE 120
GIG HARBOR WA
98335-1706
US

V. Phone/Fax

Practice location:
  • Phone: 253-858-9941
  • Fax: 253-858-1620
Mailing address:
  • Phone: 253-858-9941
  • Fax: 253-858-1620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number601510642
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number601510642
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number601510642
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberCF00002146
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMMY KVINSLAND
Title or Position: CONTRACT ADMINISTRATOR
Credential:
Phone: 253-858-9941