{
"Npi": {
"NPI": "1134583735",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROCKFORTH PHARMACY",
"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": "PO BOX 20663",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CASTRO VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94546-8663",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-878-7681",
"MailingAddressFaxNumber": "510-969-4705",
"FirstLinePracticeLocationAddress": "14624 E 14TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN LEANDRO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94578-2817",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-878-7681",
"PracticeLocationAddressFaxNumber": "510-969-4705",
"EnumerationDate": "04/09/2016",
"LastUpdateDate": "04/19/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OKWUEGBE",
"AuthorizedOfficialFirstName": "KENNETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "510-589-5989",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}