{
"Npi": {
"NPI": "1487891438",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BJRX PHARMACY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1801 E MARCH LN",
"SecondLineMailingAddress": "SUITE:B280",
"MailingAddressCityName": "STOCKTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95210-6629",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-474-2888",
"MailingAddressFaxNumber": "209-474-3328",
"FirstLinePracticeLocationAddress": "1801 E MARCH LN",
"SecondLinePracticeLocationAddress": "SUITE:B280",
"PracticeLocationAddressCityName": "STOCKTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95210-6629",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-474-2888",
"PracticeLocationAddressFaxNumber": "209-474-3328",
"EnumerationDate": "01/13/2009",
"LastUpdateDate": "01/14/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANNE",
"AuthorizedOfficialFirstName": "PRATAP",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "PHARMACIST INCHARGE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "209-474-2888",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "PHY 49785",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "PHY 49785",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY 49785",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}