{
"Npi": {
"NPI": "1861919938",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GILL PHARMACY INC. DBA LATHROP 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": "2600 MITCHELL ROAD GILL PHARMACY INC.",
"SecondLineMailingAddress": "SUITE G",
"MailingAddressCityName": "CERES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95307",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-537-4455",
"MailingAddressFaxNumber": "209-537-4456",
"FirstLinePracticeLocationAddress": "273 SPRECKELS AVE, LATHROP PHARMACY",
"SecondLinePracticeLocationAddress": "SUITE C1",
"PracticeLocationAddressCityName": "MANTECA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95336",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-923-4564",
"PracticeLocationAddressFaxNumber": "209-923-4594",
"EnumerationDate": "08/29/2017",
"LastUpdateDate": "09/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILL",
"AuthorizedOfficialFirstName": "SIMRIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "209-537-4455",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}