{
"Npi": {
"NPI": "1619350048",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GI VILLAGE PHARMACY",
"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": "300 S 1ST AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HASTINGS",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68901-6464",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "402-463-2441",
"MailingAddressFaxNumber": "402-463-2441",
"FirstLinePracticeLocationAddress": "4075 TIMBERLINE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND ISLAND",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68803-6553",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "308-385-3535",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/02/2015",
"LastUpdateDate": "07/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHLACHTER",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "402-463-2441",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "612",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}