{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CHRIS PHARMACY OF GONZALES LLC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 328",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70711-0328",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-267-5700",
"MailingAddressFaxNumber": "225-267-5707",
"FirstLinePracticeLocationAddress": "14505 HIGHWAY 44 STE 112",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GONZALES",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70737-7195",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "225-573-4578",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/02/2020",
"LastUpdateDate": "05/25/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "WARREN",
"AuthorizedOfficialMiddleName": "C",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "225-698-6000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}