{
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "350 E SIX FORKS RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RALEIGH",
"MailingAddressStateName": "NC",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "350 E SIX FORKS RD",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/20/2014",
"LastUpdateDate": "06/20/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SNOTHERLY",
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"AuthorizedOfficialTelephoneNumber": "919-624-6553",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "22678",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}