{
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"FirstLineMailingAddress": "1303 WIND SWWEPT CT.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HANAHAN",
"MailingAddressStateName": "SC",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1298 YEAMANS HALL RD",
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"PracticeLocationAddressCityName": "HANAHAN",
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"PracticeLocationAddressTelephoneNumber": "843-207-4087",
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"EnumerationDate": "11/01/2017",
"LastUpdateDate": "11/01/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMMER",
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"AuthorizedOfficialTitle": "OWNER/PHARMACIST",
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"AuthorizedOfficialCredential": "PHARMD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}