{
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"EIN": null,
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"IsOrgSubpart": "Y",
"ParentOrgLBN": "BELLS MARKET PHARMACY CORP",
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"OrgName": "BELLS MARKET PHARMACY CORP",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8330 BUSTLETON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19152-1909",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-342-6016",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8330 BUSTLETON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-342-6016",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/26/2010",
"LastUpdateDate": "01/20/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PENDRAK",
"AuthorizedOfficialFirstName": "STEVE",
"AuthorizedOfficialMiddleName": "V",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "215-342-6016",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PP482005",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}