{
"Npi": {
"NPI": "1982078887",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROSE PHARMACY, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1901 EASTGATE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLYTHEVILLE",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72315-1208",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-740-7479",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1003 N 6TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLYTHEVILLE",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72315-1707",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-740-7479",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/16/2015",
"LastUpdateDate": "11/16/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROSE",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "CHARLES",
"AuthorizedOfficialTitle": "RPH/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "PHARM.D",
"AuthorizedOfficialTelephoneNumber": "870-740-7479",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PD12030",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}