{
"Npi": {
"NPI": "1104978584",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHY COMMUNITY PHARMACY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "160 ROOSEVELT AVE",
"SecondLineMailingAddress": "SUITE 102",
"MailingAddressCityName": "YORK",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "17401-3378",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "717-812-3020",
"MailingAddressFaxNumber": "717-848-2658",
"FirstLinePracticeLocationAddress": "160 ROOSEVELT AVE",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "YORK",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "17401-3378",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "717-812-3020",
"PracticeLocationAddressFaxNumber": "717-848-2658",
"EnumerationDate": "01/17/2007",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOOK",
"AuthorizedOfficialFirstName": "MELLISA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR - WELLSPAN PHARMACY INC.",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "717-851-5895",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PP481364",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PP481364",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}