{
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"FirstLineMailingAddress": "PO BOX 1143",
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"MailingAddressCityName": "BOONEVILLE",
"MailingAddressStateName": "KY",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "99 KY 11 SOUTH",
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"PracticeLocationAddressCityName": "BOONEVILLE",
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"PracticeLocationAddressTelephoneNumber": "606-593-6337",
"PracticeLocationAddressFaxNumber": "606-593-4000",
"EnumerationDate": "11/07/2013",
"LastUpdateDate": "11/19/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MILLER",
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"AuthorizedOfficialTelephoneNumber": "606-633-4823",
"Taxonomies": {
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"TaxonomyName": "Community/Retail Pharmacy",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}