{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "B&B PHARMACY, PLLC",
"ParentOrgTIN": null,
"OrgName": "B&B PHARMACY, PLLC",
"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": "126 SHADOWMEADE LANE",
"SecondLineMailingAddress": "UNIT 2",
"MailingAddressCityName": "MOUNT WASHINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40047",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "502-538-5000",
"MailingAddressFaxNumber": "502-538-0330",
"FirstLinePracticeLocationAddress": "126 SHADOWMEADE LANE",
"SecondLinePracticeLocationAddress": "UNIT 2",
"PracticeLocationAddressCityName": "MOUNT WASHINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40047",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-538-5000",
"PracticeLocationAddressFaxNumber": "502-538-0330",
"EnumerationDate": "08/24/2020",
"LastUpdateDate": "06/07/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARGER",
"AuthorizedOfficialFirstName": "ELLEN",
"AuthorizedOfficialMiddleName": "KRAJEWSKI",
"AuthorizedOfficialTitle": "PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "502-543-8200",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}