MEDICARE: MRS. VERONICA TOVAR BANDY PHARMD

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	183500000X	Pharmacist	51736	CA

General Provider Information

NPI Number	:	1518963453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA TOVAR BANDY PHARMD

Provider Business Mailing Address
First Line	:	4978 TIMEPIECE CIR
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95219-2042
Country	:	US
Telephone Number	:	209-957-3946
Fax Number	:	209-957-3946

Provider Business Practice Location Address
First Line	:	THOMAS J LONG SCHOOL OF PHARMACY & HEALTH SCIENCES
Second Line	:	751 BROOKSIDE ROAD
City	:	STOCKTON
State	:	CA
Zip	:	95211
Country	:	US
Telephone Number	:	209-946-2363
Fax Number	:	209-946-2410

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

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