Provider Demographics
NPI:1639209240
Name:BANDY'S PRESCRIPTIONS INC
Entity Type:Organization
Organization Name:BANDY'S PRESCRIPTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BANDY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:618-283-0054
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-0296
Mailing Address - Country:US
Mailing Address - Phone:618-283-0054
Mailing Address - Fax:
Practice Address - Street 1:915 N 8TH ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1757
Practice Address - Country:US
Practice Address - Phone:618-283-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BANDY'S PRESCRIPTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00002619865OtherBCBS
IL=========001Medicaid
IL0969940001Medicare NSC