{
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"IsOrgSubpart": "N",
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"OrgName": "SOUTHMOORE PHARMACY LLC",
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"FirstLineMailingAddress": "2453 PLAZA CT STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATH",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18014",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-287-6337",
"MailingAddressFaxNumber": "484-287-6340",
"FirstLinePracticeLocationAddress": "2453 PLAZA CT STE A",
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"PracticeLocationAddressCityName": "BATH",
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"PracticeLocationAddressFaxNumber": "484-287-6340",
"EnumerationDate": "04/19/2012",
"LastUpdateDate": "01/13/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEBER",
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"AuthorizedOfficialTelephoneNumber": "484-287-6337",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PP482196",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}