{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MANNINOS FAMILY PRACTICE PHARMACY INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 1442",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAMMOND",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70404-1442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "985-542-8466",
"MailingAddressFaxNumber": "985-542-2561",
"FirstLinePracticeLocationAddress": "113 W CHARLES ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAMMOND",
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"PracticeLocationAddressPostalCode": "70401-3232",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "985-542-8466",
"PracticeLocationAddressFaxNumber": "985-542-2561",
"EnumerationDate": "06/23/2022",
"LastUpdateDate": "06/23/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANNINO",
"AuthorizedOfficialFirstName": "RICHARD",
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"AuthorizedOfficialTitle": "PHARMACIST-IN-CHARGE, OWNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "985-542-8466",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}