{
"Npi": {
"NPI": "1013935279",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CANOTE PHARMACY, 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": "545 SKAGGS ROAD",
"SecondLineMailingAddress": "SUITE 1007",
"MailingAddressCityName": "BRANSON",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65616",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-332-0565",
"MailingAddressFaxNumber": "417-332-0793",
"FirstLinePracticeLocationAddress": "545 SKAGGS ROAD",
"SecondLinePracticeLocationAddress": "SUITE 1007",
"PracticeLocationAddressCityName": "BRANSON",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "65616",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "417-332-0565",
"PracticeLocationAddressFaxNumber": "417-332-0793",
"EnumerationDate": "07/17/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BURNEY",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "PHARMACIST-IN-CHARGE, OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "417-332-0565",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "2000157696",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}