{
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"FirstLineMailingAddress": "1464 CLEVELAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBUS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43211-2760",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-298-4190",
"MailingAddressFaxNumber": "614-298-4191",
"FirstLinePracticeLocationAddress": "1464 CLEVELAND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLUMBUS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-298-4190",
"PracticeLocationAddressFaxNumber": "614-298-4191",
"EnumerationDate": "07/13/2021",
"LastUpdateDate": "07/13/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "SARAH",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "330-204-9951",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}