{
"Npi": {
"NPI": "1295372563",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BOSTON MEDICAL CENTER CORPORATION DBA BMC PHARMACY AT CODMAN SQUARE",
"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": "850 HARRISON AVE BSMT BCN7",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOSTON",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02118-4001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-414-5377",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "637 WASHINGTON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DORCHESTER",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02124-3510",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-638-8150",
"PracticeLocationAddressFaxNumber": "617-638-8149",
"EnumerationDate": "12/05/2019",
"LastUpdateDate": "12/05/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAMILTON",
"AuthorizedOfficialFirstName": "SEBASTIAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SENIOR DIRECTOR OUTPATIENT PHARMACY",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "617-414-5377",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}