Provider Demographics
NPI:1164530630
Name:BOND ENTERPRISES INC
Entity Type:Organization
Organization Name:BOND ENTERPRISES INC
Other - Org Name:OLYMPIC PHARMACY AND HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KVINSLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-858-9941
Mailing Address - Street 1:4700 POINT FOSDICK DR NW STE 120
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-858-9941
Mailing Address - Fax:253-858-1620
Practice Address - Street 1:4700 POINT FOSDICK DR NW STE 120
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-858-9941
Practice Address - Fax:253-858-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601510642332B00000X, 332BC3200X, 332BP3500X
332BX2000X, 335E00000X
WACF00002146333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9058777Medicaid
WA6118806Medicaid
WA6118806Medicaid