NPIMap

Organization Active NPI

Lifebrite Hospital Group of Early LLC

  • Community/Retail Pharmacy
  • Blakely, GA
National Provider Identifier
1922531953
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009691 Issued in GA
Legal business name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Practice address
11740 Columbia St
Blakely, GA 39823-2574
Phone
(229) 723-4841
NPI assigned
Apr 6, 2017
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Morgan Dunn
Title
Chief Executive Officer
Phone
(601) 849-6440

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009691 GA Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

11740 Columbia St
Blakely, GA 39823-2574

Mailing address

11740 Columbia St
Blakely, GA 39823-2574

National Provider Directory

National Provider Directory
Tax ID family
Lifebrite Hospital Group of Early LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1922531953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574",
            "telephone_number": "229-723-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE HOSPITAL GROUP OF EARLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "601-849-6440"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009691",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blakely, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.