{
"Npi": {
"NPI": "1982637666",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SANTA FE PHARMACY INC",
"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": "8831 37TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON HEIGHTS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11372-7736",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-651-7400",
"MailingAddressFaxNumber": "718-651-1777",
"FirstLinePracticeLocationAddress": "8831 37TH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JACKSON HEIGHTS",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11372-7736",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-651-7400",
"PracticeLocationAddressFaxNumber": "718-651-1777",
"EnumerationDate": "07/08/2006",
"LastUpdateDate": "11/02/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GADELRAB",
"AuthorizedOfficialFirstName": "NISSREN",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "SUPERVISING PHARMACIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "718-651-7400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "026153",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}