{
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"EIN": null,
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"IsOrgSubpart": "Y",
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"OrgName": "MAO PHARMACY, INC.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "5823 PATTERSON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23226-2536",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-288-1933",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3143 MAGIC HOLLOW BLVD STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-263-4774",
"PracticeLocationAddressFaxNumber": "757-263-4775",
"EnumerationDate": "08/03/2023",
"LastUpdateDate": "08/03/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OLEY",
"AuthorizedOfficialFirstName": "MARK",
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"AuthorizedOfficialTitle": "VICE-PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "804-288-3620",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
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}
]
},
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}
}