{
"Npi": {
"NPI": "1780135186",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROSAUERS FOOD AND DRUG #27",
"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": "2350 S RESERVE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MISSOULA",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59801-6447",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-721-5330",
"MailingAddressFaxNumber": "406-721-4832",
"FirstLinePracticeLocationAddress": "2350 S RESERVE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MISSOULA",
"PracticeLocationAddressStateName": "MT",
"PracticeLocationAddressPostalCode": "59801-6447",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-721-5330",
"PracticeLocationAddressFaxNumber": "406-721-4832",
"EnumerationDate": "10/20/2016",
"LastUpdateDate": "10/20/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MELVIN",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "ALLEN",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH, PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "406-721-5330",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHA-PHA-LIC-5221",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}