{
"Npi": {
"NPI": "1154666444",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CUTCHOGUE BARTHS PHARMACY INC",
"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": "73 JAGGER LANE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTHAMPTON",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11977",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-902-1865",
"MailingAddressFaxNumber": "631-998-3642",
"FirstLinePracticeLocationAddress": "28195 MAIN ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CUTCHOGUE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11935",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-734-6796",
"PracticeLocationAddressFaxNumber": "631-734-2382",
"EnumerationDate": "11/28/2012",
"LastUpdateDate": "08/01/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CASSARA",
"AuthorizedOfficialFirstName": "LOUIS",
"AuthorizedOfficialMiddleName": "VINCENT",
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "631-734-6796",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "031625",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}