Organization Active NPI

Lincolnton Investments LLC.

Doing business as Crawford & Breazeale Drug Co.

  • Community/Retail Pharmacy
  • Lincolnton, GA
National Provider Identifier
1306929468
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010650 Issued in GA
Legal business name
LINCOLNTON INVESTMENTS LLC.
Doing business as
Crawford & Breazeale Drug Co.
Practice address
125 N Washington St
Lincolnton, GA 30817
Phone
(706) 359-3343
Fax
(706) 359-7505
NPI assigned
Oct 23, 2006
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Bryce Allfrey, PHARMDNPI 1871180042
Title
Pic
Phone
(706) 359-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE010650 GA Primary

Addresses

Primary practice location

125 N Washington St
Lincolnton, GA 30817

Mailing address

PO Box 1839
Lincolnton, GA 30817-8839
Phone (706) 359-3343

Other identifiers 2

IdentifierTypeStateIssuer
00025484AMedicaidGA
2012555OtherPK

Other names 1

  • Crawford & Breazeale Drug Co. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181231001878 GA Part B Supplier - Pharmacy 0345585923 Practice locations: Lincolnton, GA

National Provider Directory

National Provider Directory
Tax ID family
Lincolnton Investments LLC2 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.

Locations

125 N Washington St
Lincolnton, GA 30817
Phone (706) 359-3343

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1306929468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1839",
            "city": "LINCOLNTON",
            "state": "GA",
            "postal_code": "308178839",
            "telephone_number": "706-359-3343",
            "fax_number": "706-359-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N WASHINGTON ST",
            "city": "LINCOLNTON",
            "state": "GA",
            "postal_code": "30817",
            "telephone_number": "706-359-3343",
            "fax_number": "706-359-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLNTON INVESTMENTS LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "ALLFREY",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "706-359-3343",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00025484A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012555",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford & Breazeale Drug Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.