{
"Npi": {
"NPI": "1437214012",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILLIPS DRUGS, 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": "PO BOX 120",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIDALIA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30475-0120",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "912-537-3049",
"MailingAddressFaxNumber": "912-537-3040",
"FirstLinePracticeLocationAddress": "306 W 1ST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIDALIA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30474-3369",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "912-537-3049",
"PracticeLocationAddressFaxNumber": "912-537-3040",
"EnumerationDate": "12/26/2006",
"LastUpdateDate": "01/09/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOURLEY",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": "HALL",
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "912-537-3049",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PHRE003663",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}