{
"Npi": {
"NPI": "1841532546",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRICEVILLE PHARMACY LLC",
"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": "2941 POINT MALLARD PKWY",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "DECATUR",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "256-350-2588",
"MailingAddressFaxNumber": "256-350-9860",
"FirstLinePracticeLocationAddress": "2941 POINT MALLARD PKWY",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "DECATUR",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "256-350-2588",
"PracticeLocationAddressFaxNumber": "256-350-9860",
"EnumerationDate": "03/20/2013",
"LastUpdateDate": "03/20/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BALDWIN",
"AuthorizedOfficialFirstName": "AUNDRIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SUPERVISING PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM D",
"AuthorizedOfficialTelephoneNumber": "256-350-2588",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "114056",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}