{
"Npi": {
"NPI": "1962636829",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WHITEHALL 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": "7240 SHERIDAN RD STE 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WHITE HALL",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71602-3272",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-850-8010",
"MailingAddressFaxNumber": "870-850-8014",
"FirstLinePracticeLocationAddress": "7240 SHERIDAN RD STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WHITE HALL",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "71602-3272",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-850-8010",
"PracticeLocationAddressFaxNumber": "870-850-8014",
"EnumerationDate": "05/07/2009",
"LastUpdateDate": "04/21/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STICE",
"AuthorizedOfficialFirstName": "FLOYD",
"AuthorizedOfficialMiddleName": "LELAN",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PD, MBA",
"AuthorizedOfficialTelephoneNumber": "870-850-8010",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "AR20608",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}