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General NPI Number Information
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NPI Number | 1013077932
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Entity Type | Organization
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Legal Business Name | BANDY'S PRESCRIPTIONS INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 915 N 8TH ST
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City | VANDALIA
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State | IL
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Zip | 62471-1757
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Country | US
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Telephone | 618-283-0054
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 296
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City | VANDALIA
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State | IL
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Zip | 62471-0296
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Country | US
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Telephone | 618-283-0054
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KEVIN DALE BANDY
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Credential | RPH
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Telephone | 618-283-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | IL
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