{
"Npi": {
"NPI": "1699967794",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CAROLINA HEALTH CARE RETAIL PHARMACY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "506 EAST CHEVES STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLORENCE",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29506",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-413-4130",
"MailingAddressFaxNumber": "843-413-4131",
"FirstLinePracticeLocationAddress": "506 EAST CHEVES STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FLORENCE",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29506",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-413-4130",
"PracticeLocationAddressFaxNumber": "843-413-4131",
"EnumerationDate": "08/13/2007",
"LastUpdateDate": "06/02/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAJAJ",
"AuthorizedOfficialFirstName": "RAJESH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "843-413-3152",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "50009549",
"LicenseNumberStateCode": "SC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}