{
"Npi": {
"NPI": "1992020028",
"EntityType": "Organization",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JACKSON LTC PHARMACY INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "266 N JACKSON AVE",
"SecondLineMailingAddress": "8B",
"MailingAddressCityName": "SAN JOSE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95116-1606",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "266 N JACKSON AVE",
"SecondLinePracticeLocationAddress": "8B",
"PracticeLocationAddressCityName": "SAN JOSE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95116-1606",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "408-251-7009",
"PracticeLocationAddressFaxNumber": "404-251-7007",
"EnumerationDate": "03/31/2010",
"LastUpdateDate": "10/14/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KATPELLY",
"AuthorizedOfficialFirstName": "SRINIVAS",
"AuthorizedOfficialMiddleName": "REDDY",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "415-464-9777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}