{
"Npi": {
"NPI": "1487194874",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COTTRILLS PHARMACY 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": "4919 ELLICOTT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORCHARD PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14127-3357",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-508-8481",
"MailingAddressFaxNumber": "716-508-8482",
"FirstLinePracticeLocationAddress": "4919 ELLICOTT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ORCHARD PARK",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14127-3357",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-508-8481",
"PracticeLocationAddressFaxNumber": "716-508-8482",
"EnumerationDate": "03/03/2017",
"LastUpdateDate": "06/06/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MELLERSKI",
"AuthorizedOfficialFirstName": "ERIN",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "CHIEF CLINICAL OFFICER/SVP",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD, CSP",
"AuthorizedOfficialTelephoneNumber": "716-508-8481",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336H0001X",
"TaxonomyName": "Home Infusion Therapy Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}