Provider Demographics
NPI:1104131135
Name:BONDI, ANTHONY B (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:B
Last Name:BONDI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1063
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445
Mailing Address - Country:US
Mailing Address - Phone:985-882-5999
Mailing Address - Fax:985-882-5111
Practice Address - Street 1:28079 US HWY 190
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445
Practice Address - Country:US
Practice Address - Phone:985-882-5999
Practice Address - Fax:985-882-5111
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.18782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1895652Medicaid