{
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "ADVANCE CARE PHARMACY PLLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "25 MEDPARK SQUARE DR STE 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOMERSET",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42503-1702",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-676-0199",
"MailingAddressFaxNumber": "606-451-7727",
"FirstLinePracticeLocationAddress": "25 MEDPARK SQUARE DR STE 4",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOMERSET",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-676-0199",
"PracticeLocationAddressFaxNumber": "606-451-7727",
"EnumerationDate": "05/05/2025",
"LastUpdateDate": "05/05/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUNGAN",
"AuthorizedOfficialFirstName": "WESTON",
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"AuthorizedOfficialCredential": "PHARMD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}