{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SMITH & PECK PHARMACY MANAGEMENT SERVICES INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "242 RIVER ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "VT",
"MailingAddressPostalCode": "05156-2306",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "802-885-4222",
"MailingAddressFaxNumber": "802-885-4223",
"FirstLinePracticeLocationAddress": "242 RIVER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPRINGFIELD",
"PracticeLocationAddressStateName": "VT",
"PracticeLocationAddressPostalCode": "05156-2306",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "802-885-4222",
"PracticeLocationAddressFaxNumber": "802-885-4223",
"EnumerationDate": "09/30/2010",
"LastUpdateDate": "12/07/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PECK",
"AuthorizedOfficialFirstName": "LESTER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "802-376-7077",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "038.0071595",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}