{
"Npi": {
"NPI": "1255348363",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SCOTTIE PHARMACY INC",
"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": "PO BOX 337",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHLANDS",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24641-0337",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-963-0284",
"MailingAddressFaxNumber": "276-963-4465",
"FirstLinePracticeLocationAddress": "1951 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHLANDS",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24641-2303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-963-0284",
"PracticeLocationAddressFaxNumber": "276-963-4465",
"EnumerationDate": "08/02/2006",
"LastUpdateDate": "07/19/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOSLOW",
"AuthorizedOfficialFirstName": "VIRGINIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACIST IN CHARGE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "276-963-0284",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "0201003542",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}