{
"Npi": {
"NPI": "1295918340",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MANCHESTER DRUGS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15 S CRANBERRY RD",
"SecondLineMailingAddress": "UNIT C",
"MailingAddressCityName": "WESTMINSTER",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21157-5101",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-857-4500",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "15 S CRANBERRY RD",
"SecondLinePracticeLocationAddress": "UNIT C",
"PracticeLocationAddressCityName": "WESTMINSTER",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21157-5101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-857-4500",
"PracticeLocationAddressFaxNumber": "410-857-4220",
"EnumerationDate": "12/12/2007",
"LastUpdateDate": "08/18/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOLTON",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "MCLEAN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "443-929-2484",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "P04695",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}