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Organization
BOND COUNTY PHARMACY LLC
Active
Organization
BOND COUNTY PHARMACY LLC
Active
Other names
Bond County Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BORNTREGER RPH (PRESIDENT)
(618) 690-5000
Entity
Organization
Contact information
Practice address
224A E HARRIS AVE, GREENVILLE, IL 62246-2150
(618) 690-5000
(618) 703-1671
Mailing address
224A E HARRIS AVE, GREENVILLE, IL 62246
(618) 690-5000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1496694
NCPDP
—
01
—
54021820
PHARMACY LICENSE
IL
Enumeration date
12/17/2020
Last updated
03/07/2023
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