{
"Npi": {
"NPI": "1194122440",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MULA FAMILY PHARMACY, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2619 CHARITY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ABBEVILLE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70510-4024",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "337-385-1250",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2619 CHARITY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ABBEVILLE",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70510-4024",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-385-1250",
"PracticeLocationAddressFaxNumber": "337-385-1247",
"EnumerationDate": "12/02/2014",
"LastUpdateDate": "06/26/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MULA",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "PHARMACIST IN CHARGE/OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "337-385-1250",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}