{
"Npi": {
"NPI": "1033614557",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GEORGE'S FAMILY 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": "480 MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKVILLE",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47012-1406",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "765-647-6251",
"MailingAddressFaxNumber": "765-647-6386",
"FirstLinePracticeLocationAddress": "330 E 5TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CONNERSVILLE",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47331-2604",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "765-825-6386",
"PracticeLocationAddressFaxNumber": "765-825-6386",
"EnumerationDate": "03/27/2018",
"LastUpdateDate": "03/27/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILLMAN",
"AuthorizedOfficialFirstName": "BLAKE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "765-647-6251",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "60006665A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}