{
"Npi": {
"NPI": "1861991895",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNINGS PHARMACY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2620 BLANDING BLVD STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIDDLEBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32068-5175",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-406-9379",
"MailingAddressFaxNumber": "904-406-9157",
"FirstLinePracticeLocationAddress": "2620 BLANDING BLVD STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIDDLEBURG",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32068-5175",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-406-9379",
"PracticeLocationAddressFaxNumber": "904-406-9157",
"EnumerationDate": "02/05/2018",
"LastUpdateDate": "07/19/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DENNING",
"AuthorizedOfficialFirstName": "DANIEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/MGR/PIC/AO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "904-652-4546",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH31140",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}