{
"Npi": {
"NPI": "1104325174",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JINAL PHARMACY LLC",
"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": "1861 PRINCETON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAWRENCEVILLE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08648-4517",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-299-4734",
"MailingAddressFaxNumber": "609-571-3151",
"FirstLinePracticeLocationAddress": "121 MAIN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PASSAIC",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07055-0001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-777-8048",
"PracticeLocationAddressFaxNumber": "973-779-2909",
"EnumerationDate": "02/06/2018",
"LastUpdateDate": "02/06/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BHATTI",
"AuthorizedOfficialFirstName": "MUJTABA",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "609-865-4364",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}