{
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"NPI": "1649748211",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BARA PHARMACY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7700 LITTLE RIVER TPKE STE 103",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANNANDALE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22003-2400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-495-3139",
"MailingAddressFaxNumber": "703-995-0664",
"FirstLinePracticeLocationAddress": "7700 LITTLE RIVER TPKE STE 103",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANNANDALE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22003-2400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-459-3139",
"PracticeLocationAddressFaxNumber": "703-995-0664",
"EnumerationDate": "11/12/2018",
"LastUpdateDate": "12/06/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHIN",
"AuthorizedOfficialFirstName": "SEOK YOUN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "571-334-4513",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}