{
"Npi": {
"NPI": "1992590566",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEDICINE SHOPPE 2000 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": "6732 BRODIE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUBLIN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43017-8046",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-412-7442",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "114 N MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BALTIMORE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43105-1210",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-862-4240",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/14/2025",
"LastUpdateDate": "04/15/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IBRAHIM",
"AuthorizedOfficialFirstName": "TAMER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "330-412-7442",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}