{
"Npi": {
"NPI": "1245650225",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "BAYSTATE MEDICAL CENTER INC",
"ParentOrgTIN": null,
"OrgName": "BAYSTATE PHARMACY",
"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": "PO BOX 798",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "01101-0798",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "413-794-9009",
"MailingAddressFaxNumber": "413-794-9013",
"FirstLinePracticeLocationAddress": "50 WASON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPRINGFIELD",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "01107-1132",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "413-794-9009",
"PracticeLocationAddressFaxNumber": "413-794-9013",
"EnumerationDate": "04/17/2014",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KERR",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "JAMES",
"AuthorizedOfficialTitle": "CHIEF PHARMACY OFFICER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "413-794-3178",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "DS89896",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}