{
"Npi": {
"NPI": "1588050983",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RAINBOW PHARMACY, 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 631255",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LANAI CITY",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96763-1255",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-565-9333",
"MailingAddressFaxNumber": "808-565-9332",
"FirstLinePracticeLocationAddress": "431 SEVENTH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LANAI CITY",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96763",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-565-9332",
"PracticeLocationAddressFaxNumber": "808-565-9333",
"EnumerationDate": "04/13/2015",
"LastUpdateDate": "09/10/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHUSTER",
"AuthorizedOfficialFirstName": "KERT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHARMACIST-IN-CHARGE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "808-879-9924",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "PHY885",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": "PHY885",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY885",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}