{
"Npi": {
"NPI": "1629588454",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEIGHBORHOOD PHARMACY 0002 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 685",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WICHITA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67201-0685",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-665-4427",
"MailingAddressFaxNumber": "888-252-7110",
"FirstLinePracticeLocationAddress": "328 E PAWNEE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67211-4847",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-665-4427",
"PracticeLocationAddressFaxNumber": "888-252-7110",
"EnumerationDate": "10/06/2017",
"LastUpdateDate": "06/16/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OTUONYE",
"AuthorizedOfficialFirstName": "EBUBE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "316-665-4427",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "2-103547",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}