Provider Demographics
NPI:1336243393
Name:BOND PHARMACY INC
Entity Type:Organization
Organization Name:BOND PHARMACY INC
Other - Org Name:ADVANCED INFUSION SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-988-1700
Mailing Address - Street 1:623 HIGHLAND COLONY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-6077
Mailing Address - Country:US
Mailing Address - Phone:601-988-1700
Mailing Address - Fax:601-988-1701
Practice Address - Street 1:623 HIGHLAND COLONY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6077
Practice Address - Country:US
Practice Address - Phone:601-988-1700
Practice Address - Fax:601-988-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336S0011X
PANP000010333600000X
MS04274/2.03336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0440837Medicaid
2047110OtherPK
MS05275262Medicaid
1216710001Medicare NSC
512G880001Medicare PIN