{
"Npi": {
"NPI": "1477586923",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SELMAR DRUG CO",
"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": "20 BROAD ST",
"SecondLineMailingAddress": "CENTER DRUG STORE",
"MailingAddressCityName": "BLOOMFIELD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07003",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-748-8296",
"MailingAddressFaxNumber": "973-566-9043",
"FirstLinePracticeLocationAddress": "20 BROAD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLOOMFIELD",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07003",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-748-8296",
"PracticeLocationAddressFaxNumber": "973-566-9043",
"EnumerationDate": "07/08/2006",
"LastUpdateDate": "07/23/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAGIN",
"AuthorizedOfficialFirstName": "HARRY",
"AuthorizedOfficialMiddleName": "BART",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "973-748-8296",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "28RS00030200",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}