{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "APOTHECA LLC",
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"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1299",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIDGWAY",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81432-1299",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-626-4432",
"MailingAddressFaxNumber": "970-626-4032",
"FirstLinePracticeLocationAddress": "171 N. CORA ST.",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "RIDGWAY",
"PracticeLocationAddressStateName": "CO",
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"PracticeLocationAddressTelephoneNumber": "970-626-4432",
"PracticeLocationAddressFaxNumber": "970-626-4032",
"EnumerationDate": "04/17/2018",
"LastUpdateDate": "05/22/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COMMON",
"AuthorizedOfficialFirstName": "MICHELLE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PIC, MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "970-728-0488",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
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}
}