Bond County Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BOND COUNTY PHARMACY LLC

Doing business as

Bond County Pharmacy

Practice address

224A E Harris Ave
Greenville, IL 62246-2150

Phone

(618) 690-5000

Fax

(618) 703-1671

NPI assigned

Dec 17, 2020

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Borntreger, RPH

Title

President

Phone

(618) 690-5000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Bond County Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in IL3 enrollments

Enrollment records 3

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Cains Drug Store Inc

  dba Cains Drug Store

  • Community/Retail Pharmacy
  • Vandalia, IL
  • NPI 1568486165

  O20060206000206

  Same enrollment

Tax ID family

Bond County Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bond County Pharmacy LLC

  • Long Term Care Pharmacy
  • Greenville, IL
  • NPI 1174324917
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Cains Drug Store Inc

  dba Cains Drug Store

  • Community/Retail Pharmacy
  • Vandalia, IL
  • NPI 1568486165

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darryl Paul Tjaden

  • Pharmacist
  • Vandalia, IL
  • NPI 1467055160
  NPD

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1447846902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224A E HARRIS AVE",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "62246",
            "telephone_number": "618-690-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224A E HARRIS AVE",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462150",
            "telephone_number": "618-690-5000",
            "fax_number": "618-703-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOND COUNTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "BORNTREGER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-690-5000",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "54021820",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1496694",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bond County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bond County Community Unit No. 2
• Bond County Health Department (Dental Clinic)
• Bond County Health Department
• Bond County Health Department (Prairie Counseling Center)
• Bond County Pharmacy LLC
• Bond County Senior Citizens Center
• Bond County Treasurer (Bond County Health Department)
• Bond County Treasurer
• Bond County Treasurer (Bond County Health Department)
• Bond County Treasurer (Bond County Health Department)

• Community/Retail Pharmacy in Greenville, IL
• Providers in Greenville, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.