Bandy, Gary J

Bandy, Gary J is an sole proprietor health care provider with primary practice located at 905 Grand Ave , Johnston City IL 62951-1219. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Bandy, Gary J can be contacted via phone (618) 983-8272.

Contact Information

Primary practice address
905 Grand Ave Johnston City IL 62951-1219
Phone: (618) 983-8272
Fax: (618) 983-7871
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X Illinois

Profile Details

NPI number 1205907664
LBN Legal business name Bandy, Gary J
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205907664 NPPES
Illinois MEDICAID 371243554001

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