{
"Npi": {
"NPI": "1962753764",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PILL BOX 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": "1329 S MAIN ST",
"SecondLineMailingAddress": "UNIT C",
"MailingAddressCityName": "SAPULPA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74066-5500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-512-6635",
"MailingAddressFaxNumber": "918-512-6658",
"FirstLinePracticeLocationAddress": "1329 S MAIN ST UNIT C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAPULPA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74066-5505",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-512-6635",
"PracticeLocationAddressFaxNumber": "918-512-6638",
"EnumerationDate": "09/20/2012",
"LastUpdateDate": "07/09/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAST",
"AuthorizedOfficialFirstName": "MELINDA",
"AuthorizedOfficialMiddleName": "KAY",
"AuthorizedOfficialTitle": "OWNER/PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "918-512-6635",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "11-6064",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}