{
"Npi": {
"NPI": "1255673745",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAGRANGE 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": "1520 ROUTE 55",
"SecondLineMailingAddress": "UNIT #16",
"MailingAddressCityName": "LAGRANGEVILLE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12540-5236",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "845-447-1343",
"MailingAddressFaxNumber": "845-384-1115",
"FirstLinePracticeLocationAddress": "1520 ROUTE 55",
"SecondLinePracticeLocationAddress": "UNIT #16",
"PracticeLocationAddressCityName": "LAGRANGEVILLE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12540-5236",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "845-447-1343",
"PracticeLocationAddressFaxNumber": "845-384-1115",
"EnumerationDate": "03/22/2013",
"LastUpdateDate": "05/09/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAPO",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "845-447-1343",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "031906",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}