{
"Npi": {
"NPI": "1326459967",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUPERVALU PHARMACIES INC",
"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": "11840 VALLEY VIEW RD",
"SecondLineMailingAddress": "ATTN: MANAGED CARE PHARMACY DEPT.",
"MailingAddressCityName": "EDEN PRAIRIE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55344-3643",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-828-4588",
"MailingAddressFaxNumber": "952-947-3470",
"FirstLinePracticeLocationAddress": "200 PIONEER TRL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHASKA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55318-1169",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-368-2849",
"PracticeLocationAddressFaxNumber": "952-368-2868",
"EnumerationDate": "05/16/2014",
"LastUpdateDate": "10/03/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAPP",
"AuthorizedOfficialFirstName": "AARON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF PHARMACY SERVICES",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "952-828-4026",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "264448",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}