{
"Npi": {
"NPI": "1891043592",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUU DRUG STORES 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": "3811 SCHOOL LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DREXEL HILL",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19026-3113",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-626-4549",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5805 RISING SUN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19120-1125",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-821-2883",
"PracticeLocationAddressFaxNumber": "215-821-2708",
"EnumerationDate": "08/28/2012",
"LastUpdateDate": "11/12/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LUU",
"AuthorizedOfficialFirstName": "TRUONG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACY OWNER",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "610-761-6625",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PP482298",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}