{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "JENNIE STUART SATELLITE PHARMACY",
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"NamePrefix": null,
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"FirstLineMailingAddress": "1724 KENTON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOPKINSVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42240-1981",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "270-887-0348",
"MailingAddressFaxNumber": "270-887-0201",
"FirstLinePracticeLocationAddress": "1724 KENTON ST",
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"PracticeLocationAddressCityName": "HOPKINSVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-887-0348",
"PracticeLocationAddressFaxNumber": "270-887-0201",
"EnumerationDate": "01/22/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEEPLES",
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"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "270-887-0100",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": "P02415",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}