{
"Npi": {
"NPI": "1649901265",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROSE ROCK 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": "12100 S YUKON AVE STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLENPOOL",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74033-6621",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-321-4054",
"MailingAddressFaxNumber": "918-552-1030",
"FirstLinePracticeLocationAddress": "12100 S YUKON AVE STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENPOOL",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74033-6621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-321-4054",
"PracticeLocationAddressFaxNumber": "918-552-1030",
"EnumerationDate": "06/23/2022",
"LastUpdateDate": "06/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREUEL",
"AuthorizedOfficialFirstName": "COLBY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHARMACIST IN CHARGE",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM. D.",
"AuthorizedOfficialTelephoneNumber": "918-321-4054",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}