{
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"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "Y",
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"OrgName": "CVS/PHARMACY",
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"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9069 W LAKE PLEASANT PKWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEORIA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85382-8361",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-376-0549",
"MailingAddressFaxNumber": "623-362-3431",
"FirstLinePracticeLocationAddress": "9069 W LAKE PLEASANT PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PEORIA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85382-8361",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-376-0549",
"PracticeLocationAddressFaxNumber": "623-362-3431",
"EnumerationDate": "04/01/2014",
"LastUpdateDate": "04/01/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MEYER",
"AuthorizedOfficialFirstName": "SHELLEY",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "623-376-0549",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "S018742",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}