{
"Npi": {
"NPI": "1972022051",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ROCK PHARMACY LLC",
"ParentOrgTIN": null,
"OrgName": "ROCK 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": "1201 S MAIN ST STE 121",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOERNE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78006-2839",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "830-357-5052",
"MailingAddressFaxNumber": "830-357-5053",
"FirstLinePracticeLocationAddress": "1201 S MAIN ST STE 121",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOERNE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78006-2839",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "830-357-5052",
"PracticeLocationAddressFaxNumber": "830-357-5053",
"EnumerationDate": "09/11/2017",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ORAEKWE",
"AuthorizedOfficialFirstName": "PETER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D",
"AuthorizedOfficialTelephoneNumber": "830-357-5052",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "27952",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}