{
"Npi": {
"NPI": "1689988271",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WATSONS PHARMACY INC",
"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": "8622 GARVEY AVE",
"SecondLineMailingAddress": "STE 102",
"MailingAddressCityName": "ROSEMEAD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91770-3293",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-280-2223",
"MailingAddressFaxNumber": "626-280-8243",
"FirstLinePracticeLocationAddress": "8622 GARVEY AVE",
"SecondLinePracticeLocationAddress": "STE 102",
"PracticeLocationAddressCityName": "ROSEMEAD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91770-3291",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-280-2223",
"PracticeLocationAddressFaxNumber": "626-280-8243",
"EnumerationDate": "08/06/2010",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHEUNG",
"AuthorizedOfficialFirstName": "PETER",
"AuthorizedOfficialMiddleName": "KA-HUNG",
"AuthorizedOfficialTitle": "PRESIDENT/PIC",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "626-280-2223",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PHY 50348",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY 50348",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}