{
"Npi": {
"NPI": "1629626163",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEADOWLANDS 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": "40 MEADOWLANDS PKWAY",
"SecondLineMailingAddress": "MEADOWLANDS PKWAY",
"MailingAddressCityName": "SECAUCUS",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07094",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "201-330-0063",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "40",
"SecondLinePracticeLocationAddress": "MEADOWLANDS PKWAY",
"PracticeLocationAddressCityName": "SECAUCUS",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07094",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "201-330-0063",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/28/2019",
"LastUpdateDate": "08/28/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
"AuthorizedOfficialFirstName": "PARUL",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "201-330-0063",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}