{
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"FirstLineMailingAddress": "PO BOX 328",
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"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44805-0328",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-281-4040",
"MailingAddressFaxNumber": "419-282-9841",
"FirstLinePracticeLocationAddress": "849 SMITH RD",
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"PracticeLocationAddressCityName": "ASHLAND",
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"PracticeLocationAddressTelephoneNumber": "419-281-4040",
"PracticeLocationAddressFaxNumber": "419-282-9841",
"EnumerationDate": "10/05/2026",
"LastUpdateDate": "10/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUGGINS",
"AuthorizedOfficialFirstName": "BETSY",
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"AuthorizedOfficialTitle": "PHARMACY MANAGER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "419-281-4040",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}