{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KERR DRUG",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1106 KINGOLD BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SNOW HILL",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28580-1619",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-747-6512",
"MailingAddressFaxNumber": "747-747-6515",
"FirstLinePracticeLocationAddress": "1106 KINGOLD BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SNOW HILL",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28580-1619",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-747-6512",
"PracticeLocationAddressFaxNumber": "747-747-6515",
"EnumerationDate": "05/21/2010",
"LastUpdateDate": "05/21/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
"AuthorizedOfficialFirstName": "ROSHNI",
"AuthorizedOfficialMiddleName": "HIREN",
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "252-747-9189",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "18839",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}