{
"Npi": {
"NPI": "1215219241",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WALGREENS",
"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 NE SABAL PALM WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JENSEN BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34957-6509",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-215-2490",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1661 NW SAINT LUCIE WEST BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT ST LUCIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34986-2106",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-873-1892",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/15/2011",
"LastUpdateDate": "09/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MENESICK",
"AuthorizedOfficialFirstName": "KARA",
"AuthorizedOfficialMiddleName": "DENYSE",
"AuthorizedOfficialTitle": "REGISTERED IMMUNIZING PHARMACIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM D.",
"AuthorizedOfficialTelephoneNumber": "772-215-2490",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PS47625",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}