NPIMap

Individual provider Active NPI

Eric Scott Bandy, RPH

  • Pharmacist
  • Salem, IL
National Provider Identifier
1053089367
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051286658 Issued in IL
Practice address
1413 W Whittaker St
Salem, IL 62881-2015
Phone
(618) 548-4000
Fax
(618) 548-3784
NPI assigned
Sep 1, 2021
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051286658 IL Primary

Addresses

Primary practice location

1413 W Whittaker St
Salem, IL 62881-2015

Mailing address

PO Box 546
Salem, IL 62881-0546
Phone (618) 548-4000

Other practice location 1

310 S. Main St.
Wayne City, ID 62895
Phone (618) 895-2844

Other practice location 2

207 Huron St
Irvington, IL 62848-1056
Phone (618) 249-6905

Other practice location 3

817 E McCord St
Centralia, IL 62801-3044
Phone (618) 533-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051286658ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bandy's LTC LLC Current Accepting new patients
Bandys Pharmacy Inc Current Accepting new patients
Bandys Pharmacy Inc Current Accepting new patients
Bandys Apothecary Shops Inc Past Accepting new patients
Bandys Apothecary Shops, Inc PastSince Dec 5, 2021 Accepting new patients

Locations

1413 W Whittaker St
Salem, IL 62881
Phone (618) 548-4000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1053089367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628810546",
            "telephone_number": "618-548-4000",
            "fax_number": "618-548-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W WHITTAKER ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812015",
            "telephone_number": "618-548-4000",
            "fax_number": "618-548-3784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 S. Main St.",
            "address_purpose": "LOCATION",
            "city": "Wayne City",
            "state": "ID",
            "postal_code": "62895",
            "country_code": "US",
            "telephone_number": "618-895-2844",
            "fax_number": "618-582-8050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 Huron St",
            "address_purpose": "LOCATION",
            "city": "Irvington",
            "state": "IL",
            "postal_code": "628481056",
            "country_code": "US",
            "telephone_number": "618-249-6905",
            "fax_number": "618-249-8384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 E McCord St",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "IL",
            "postal_code": "628013044",
            "country_code": "US",
            "telephone_number": "618-533-3300",
            "fax_number": "618-533-3302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDY",
        "first_name": "ERIC",
        "middle_name": "SCOTT",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.