{
"Npi": {
"NPI": "1619206737",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FREER PHARMACY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1520",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FREER",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78357-1520",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "361-394-4433",
"MailingAddressFaxNumber": "367-394-7744",
"FirstLinePracticeLocationAddress": "717 E. RILEY ST.",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "FREER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78357-1520",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "361-394-7733",
"PracticeLocationAddressFaxNumber": "367-394-7744",
"EnumerationDate": "12/19/2009",
"LastUpdateDate": "06/24/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PENA",
"AuthorizedOfficialFirstName": "JOSE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "361-394-7733",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "26728",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}