{
"Npi": {
"NPI": "1699355057",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LEELA LIFE SCIENCES 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": "309 CENTRAL AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BUTNER",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27509-2315",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-575-6571",
"MailingAddressFaxNumber": "919-575-9306",
"FirstLinePracticeLocationAddress": "309 CENTRAL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BUTNER",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27509-2315",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-575-6571",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/10/2021",
"LastUpdateDate": "06/16/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
"AuthorizedOfficialFirstName": "HIREN",
"AuthorizedOfficialMiddleName": "CHANDUBHAI",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "919-575-6571",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}