{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DRUGTOWN PHARMACY INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10121 METROPOLITAN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FOREST HILLS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11375-6647",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-793-6747",
"MailingAddressFaxNumber": "718-793-6748",
"FirstLinePracticeLocationAddress": "10121 METROPOLITAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FOREST HILLS",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11375-6647",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-793-6747",
"PracticeLocationAddressFaxNumber": "718-793-6748",
"EnumerationDate": "10/09/2012",
"LastUpdateDate": "04/09/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FATA",
"AuthorizedOfficialFirstName": "FRANCIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SHAREHOLDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "718-793-6747",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}