{
"Npi": {
"NPI": "1982882429",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "APOTHECARY BOTANICA",
"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": "417 MACE BLVD",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "DAVIS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95618-6053",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "530-231-6520",
"MailingAddressFaxNumber": "530-231-6429",
"FirstLinePracticeLocationAddress": "417 MACE BLVD",
"SecondLinePracticeLocationAddress": "SUITE D",
"PracticeLocationAddressCityName": "DAVIS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95618-6053",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "530-231-6520",
"PracticeLocationAddressFaxNumber": "530-231-6429",
"EnumerationDate": "02/06/2008",
"LastUpdateDate": "06/17/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRAZILL",
"AuthorizedOfficialFirstName": "BRADLEY",
"AuthorizedOfficialMiddleName": "JAY",
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "530-231-6520",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}