{
"Npi": {
"NPI": "1225048978",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAKESHORE PHARMACIES, 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": "115 LOCUST ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALLEGAN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49010-1301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-673-4188",
"MailingAddressFaxNumber": "269-673-6773",
"FirstLinePracticeLocationAddress": "115 LOCUST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALLEGAN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49010-1301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "269-673-4188",
"PracticeLocationAddressFaxNumber": "269-673-6773",
"EnumerationDate": "08/08/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALEXANDER",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": "MARK",
"AuthorizedOfficialTitle": "PRESIDENT/PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "269-673-4188",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "5301005598",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}