{
"Npi": {
"NPI": "1356309348",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRIFFIN'S PRESCRIPTION SHOP,INC.",
"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": "1408 TEBEAU ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAYCROSS",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31501-5325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "912-283-3010",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1408 TEBEAU ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WAYCROSS",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31501-5325",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "912-283-3010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/02/2006",
"LastUpdateDate": "12/21/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRIFFIN",
"AuthorizedOfficialFirstName": "PERRY",
"AuthorizedOfficialMiddleName": "DONALD",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "912-283-3010",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHRE005627",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}