{
"Npi": {
"NPI": "1568012383",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MOORE'S PHARMACY LENA LLC",
"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": "PO BOX 80",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LENA",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39094-0080",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-780-2757",
"MailingAddressFaxNumber": "601-724-9438",
"FirstLinePracticeLocationAddress": "1212 GRAND AVENUE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LENA",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39094",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-780-2757",
"PracticeLocationAddressFaxNumber": "601-724-9438",
"EnumerationDate": "09/13/2019",
"LastUpdateDate": "09/29/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "BRETT",
"AuthorizedOfficialMiddleName": "CHAPIN",
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "601-706-5417",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}