Allen Pharmacy Group, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009890 Issued in GA

Legal business name

ALLEN PHARMACY GROUP, LLC

Doing business as

Tifton Drug Company

Practice address

602 Love Ave
Tifton, GA 31794-4406

Phone

(229) 396-5552

Fax

(229) 396-5558

NPI assigned

Jan 2, 2013

Last updated

Sep 9, 2020By 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

Mr. Troy M Allen

Title

Cfo/Owner

Phone

(229) 563-1143

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tifton Drug Company Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1922344498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944406",
            "telephone_number": "229-396-5552",
            "fax_number": "229-396-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944406",
            "telephone_number": "229-396-5552",
            "fax_number": "229-396-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN PHARMACY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-02",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO/OWNER",
        "authorized_official_telephone_number": "229-563-1143",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003130185A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tifton Drug Company",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tifton Drug Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ibrahim Al Marei, MD
• Omar Al-Rusan, MD
• William R. Alexander IV, D.O.
• Allen M. Vickers, DMD
• Allen Pharmacy Group, LLC (Tifton Drug Company)
• Justin Richard Allen
• Allergy & Dermatology Associates of Tifton PC (Allergy, Asthma, & Sinsus Clinic)
• Allhealth Choice, LLC
• Allhealth Choice, LLC
• Raymond Alvarez, DO

• Community/Retail Pharmacy in Tifton, GA
• Providers in Tifton, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.