{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SPECIALTY SCRIPT RX LLC",
"LastName": null,
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"NamePrefix": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "259 BROADWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LYNBROOK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11563-3243",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-561-0600",
"MailingAddressFaxNumber": "516-561-0601",
"FirstLinePracticeLocationAddress": "259 BROADWAY",
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"PracticeLocationAddressCityName": "LYNBROOK",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressTelephoneNumber": "516-561-0600",
"PracticeLocationAddressFaxNumber": "516-561-0601",
"EnumerationDate": "04/04/2019",
"LastUpdateDate": "04/04/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TARNARIDER",
"AuthorizedOfficialFirstName": "ALEX",
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"AuthorizedOfficialTitle": "MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "516-561-0600",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}