{
"Npi": {
"NPI": "1770370975",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GAINESVILLE HEALTH AND WELLNESS 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": "935 GREEN ST NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GAINESVILLE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30501-3325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-532-6253",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1314 W RIDGE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GAINESVILLE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30501-6932",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-532-6253",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/22/2025",
"LastUpdateDate": "04/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BARTON",
"AuthorizedOfficialFirstName": "SCOTTIE",
"AuthorizedOfficialMiddleName": "DWAYNE",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "770-532-6253",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0002X",
"TaxonomyName": "Clinic Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}