{
"Npi": {
"NPI": "1770606139",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "APOTHECARY SHOPPE 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": "2500 CHERRY AVE",
"SecondLineMailingAddress": "SUITE NUMBER 101",
"MailingAddressCityName": "BREMERTON",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98310-4202",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-479-4900",
"MailingAddressFaxNumber": "360-373-0869",
"FirstLinePracticeLocationAddress": "2500 CHERRY AVE",
"SecondLinePracticeLocationAddress": "SUITE NUMBER 101",
"PracticeLocationAddressCityName": "BREMERTON",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98310-4202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-479-4900",
"PracticeLocationAddressFaxNumber": "360-373-0869",
"EnumerationDate": "04/09/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "ALEXANDER",
"AuthorizedOfficialTitle": "OWNER AND MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "B.S. PHARMACY",
"AuthorizedOfficialTelephoneNumber": "360-479-4900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "CF00002158",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}