LBG Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LBG PHARMACY INC

Practice address

116 2ND Ave NW
Mandan, ND 58554-3152

Phone

(701) 663-1151

Fax

(701) 663-4514

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Lynn Gustafson, RPH

Title

Owner Pharmacist

Phone

(701) 663-1151

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1265504054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 2ND AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 2ND AVE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543152",
            "telephone_number": "701-663-1151",
            "fax_number": "701-663-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LBG PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "701-663-1151",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ND",
            "license": "620",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21431",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3503225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelyn Norma Lang
• Monica L. Lang, DPT
• Darwin K Lange, MD
• Cheryl Lantz
• Keith Larson
• Leah Brady, DDS, PC
• Courtney Nicole Ledger, PT, DPT
• Pamela Lee, LPN
• Leidenix PC
• Rachel Ann Leigh

• Community/Retail Pharmacy in Mandan, ND
• Providers in Mandan, ND by specialty
• Community/Retail Pharmacy in North Dakota

• 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.