NPIMap

Organization Active NPI

CLB Pharmacy Group LLC

Doing business as Friendly City Pharmacy on 2nd LTC

  • Long Term Care Pharmacy
  • Tifton, GA
National Provider Identifier
1073334876
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CLB PHARMACY GROUP LLC
Doing business as
Friendly City Pharmacy on 2nd LTC
Practice address
717 2ND Street W
Tifton, GA 31794
Phone
(229) 382-3711
NPI assigned
Oct 23, 2024
Organization subpart
Yes
Parent organization
CLB PHARMACY GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Lucas Brown
Title
Owner
Phone
(229) 563-6689

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

717 2ND Street W
Tifton, GA 31794

Mailing address

717 2ND Street W
Tifton, GA 31794

Other names 1

  • Friendly City Pharmacy on 2nd LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CLB Pharmacy Group LLC2 organizations share this tax ID, including this one
Part of
CLB Pharmacy Group LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1073334876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 2ND STREET W",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 2ND STREET W",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-382-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLB PHARMACY GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLB PHARMACY GROUP LLC",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-563-6689"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendly City Pharmacy on 2nd LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.