{
"Npi": {
"NPI": "1275575730",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMPLETE CARE PHARMACY PLLC",
"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": "572 MORTON BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAZARD",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41701-9473",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-487-1910",
"MailingAddressFaxNumber": "606-439-1196",
"FirstLinePracticeLocationAddress": "572 MORTON BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAZARD",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41701-9473",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-487-1910",
"PracticeLocationAddressFaxNumber": "606-439-1196",
"EnumerationDate": "06/11/2006",
"LastUpdateDate": "06/27/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "CYNTHIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACIST / MEMBER PLIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "606-487-1910",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "P07067",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}