{
"Npi": {
"NPI": "1669414967",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEWPORT NEWS PHARMACY 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": "9555 KINGS CHARTER DR",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "ASHLAND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23005-7994",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-412-2533",
"MailingAddressFaxNumber": "888-550-0017",
"FirstLinePracticeLocationAddress": "9555 KINGS CHARTER DR STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHLAND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23005-7994",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-412-2533",
"PracticeLocationAddressFaxNumber": "888-550-0017",
"EnumerationDate": "06/12/2006",
"LastUpdateDate": "05/02/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOMMER",
"AuthorizedOfficialFirstName": "STEPHEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VP OF FINANCE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "314-965-4700",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "0201004065",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}