Provider Demographics
NPI:1851684369
Name:BOND, AGNES ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:ANNE
Last Name:BOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SHELDONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6281
Mailing Address - Country:US
Mailing Address - Phone:508-695-5784
Mailing Address - Fax:
Practice Address - Street 1:510 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-2147
Practice Address - Country:US
Practice Address - Phone:508-672-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23187183500000X
RIRPH04868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist