{
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"EIN": null,
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"IsOrgSubpart": "Y",
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"ParentOrgTIN": null,
"OrgName": "TAYLOR PHARMACY GROUP, INC.",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 95",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT GEORGE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31562-0095",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "912-843-8280",
"MailingAddressFaxNumber": "912-843-2456",
"FirstLinePracticeLocationAddress": "12995 FLORIDA AVE STE B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT GEORGE",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "912-843-8280",
"PracticeLocationAddressFaxNumber": "912-843-2456",
"EnumerationDate": "12/27/2022",
"LastUpdateDate": "12/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TAYLOR",
"AuthorizedOfficialFirstName": "JILLIAN",
"AuthorizedOfficialMiddleName": "BROOKE",
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "912-288-1898",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}