{
"Npi": {
"NPI": "1275998890",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KENNEDY 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": "1 LINCOLN HWY",
"SecondLineMailingAddress": "STORE # 3",
"MailingAddressCityName": "EDISON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08820-3962",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-515-9500",
"MailingAddressFaxNumber": "732-515-9503",
"FirstLinePracticeLocationAddress": "1 LINCOLN HWY",
"SecondLinePracticeLocationAddress": "STORE # 3",
"PracticeLocationAddressCityName": "EDISON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08820-3962",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-515-9500",
"PracticeLocationAddressFaxNumber": "732-515-9503",
"EnumerationDate": "12/26/2015",
"LastUpdateDate": "03/25/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VORA",
"AuthorizedOfficialFirstName": "HEMANT",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "PHARMACIST-IN-CHARGE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "732-515-9500",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "APPLICATION IN PROCE",
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}