{
"Npi": {
"NPI": "1821021809",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BELLEVUE PHARMACY, INC",
"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": "PO BOX 653",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDLOTHIAN",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23114",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-264-0458",
"MailingAddressFaxNumber": "804-264-4588",
"FirstLinePracticeLocationAddress": "4038 MACARTHUR AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23227",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-264-0458",
"PracticeLocationAddressFaxNumber": "804-264-4588",
"EnumerationDate": "07/10/2006",
"LastUpdateDate": "07/20/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MURRAY",
"AuthorizedOfficialFirstName": "LORENZO",
"AuthorizedOfficialMiddleName": "T.",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "804-264-0458",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "0201003214",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}