{
"Npi": {
"NPI": "1013015049",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EXTENSIVE PHARMACEUTICAL SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "306 N QUEEN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KINSTON",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28501-4932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-527-1593",
"MailingAddressFaxNumber": "252-527-1893",
"FirstLinePracticeLocationAddress": "306 N QUEEN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KINSTON",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28501-4932",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-527-1593",
"PracticeLocationAddressFaxNumber": "252-527-1893",
"EnumerationDate": "09/21/2006",
"LastUpdateDate": "09/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITLEY",
"AuthorizedOfficialFirstName": "GLENN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "252-527-1593",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "10268",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}