{
"Npi": {
"NPI": "1487884060",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHARMEX PHARMACY",
"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": "1091 RIVER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKEWOOD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08701-5641",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-730-7700",
"MailingAddressFaxNumber": "732-612-1187",
"FirstLinePracticeLocationAddress": "1091 RIVER AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKEWOOD",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08701-5641",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-730-7700",
"PracticeLocationAddressFaxNumber": "732-612-1187",
"EnumerationDate": "07/17/2009",
"LastUpdateDate": "12/07/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEBER",
"AuthorizedOfficialFirstName": "ISRAEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "732-730-7700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "28RS00696900",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}