{
"Npi": {
"NPI": "1013338847",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMER'S UPTOWN PHARMACY, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2402 W PIERCE ST",
"SecondLineMailingAddress": "2B",
"MailingAddressCityName": "CARLSBAD",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "88220-3537",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "575-885-4002",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2800 N MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROSWELL",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "88201-6500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "575-885-4002",
"PracticeLocationAddressFaxNumber": "575-885-5714",
"EnumerationDate": "12/20/2013",
"LastUpdateDate": "12/20/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUNGAN",
"AuthorizedOfficialFirstName": "NEAL",
"AuthorizedOfficialMiddleName": "CLIFFORD",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "575-885-4002",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}