{
"Npi": {
"NPI": "1982737649",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAWTUXET VALLEY PRESCRIPTION & SURGICAL CENTER,INC",
"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": "59 SANDY BOTTOM RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COVENTRY",
"MailingAddressStateName": "RI",
"MailingAddressPostalCode": "02816-5863",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "401-821-5000",
"MailingAddressFaxNumber": "401-821-5016",
"FirstLinePracticeLocationAddress": "59 SANDY BOTTOM RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COVENTRY",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02816-5863",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-821-5000",
"PracticeLocationAddressFaxNumber": "401-821-5016",
"EnumerationDate": "03/13/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GILMORE",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF OPERATIONS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "401-821-0600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHA00001",
"LicenseNumberStateCode": "RI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}