{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "WALGREEN'S PHARMACY",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1220 DARREN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORTSMOUTH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23701-3731",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-864-2612",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "700 FREDERICK BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORTSMOUTH",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23707-3314",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-391-9123",
"PracticeLocationAddressFaxNumber": "757-391-9140",
"EnumerationDate": "01/17/2012",
"LastUpdateDate": "01/17/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "CURTIS",
"AuthorizedOfficialMiddleName": "DARNELL",
"AuthorizedOfficialTitle": "STAFF PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "757-391-9123",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1835P1200X",
"TaxonomyName": "Pharmacotherapy Pharmacist",
"LicenseNumber": "0202207335",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}