MEDICARE: BOND PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1386129500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOND PHARMACY, INC.

Provider Business Mailing Address
First Line	:	623 HIGHLAND COLONY PKWY STE 100
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-6077
Country	:	US
Telephone Number	:	769-300-4313
Fax Number	:

Provider Business Practice Location Address
First Line	:	1166 E WARNER RD STE 101Q
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-3065
Country	:	US
Telephone Number	:	877-443-4006
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SIMON CASTELLANOS
Credential	:
Telephone Number	:	601-988-1700

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	11/02/2021

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