{
"Npi": {
"NPI": "1720369994",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BEAUMONT PHARMACY",
"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": "264 INVERNESS CENTER DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35242",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-991-7171",
"MailingAddressFaxNumber": "205-991-7179",
"FirstLinePracticeLocationAddress": "264 INVERNESS CENTER DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BIRMINGHAM",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35242-4834",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-991-7171",
"PracticeLocationAddressFaxNumber": "205-991-7179",
"EnumerationDate": "09/01/2011",
"LastUpdateDate": "01/29/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HONEA",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "JEFFERY",
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "IV",
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "205-678-7755",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "39917",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}