{
  "npi": "1942773213",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "RPH",
    "authorized_official_first_name": "JEREMY",
    "authorized_official_last_name": "POWELL",
    "authorized_official_telephone_number": "3187699751",
    "authorized_official_title_or_position": "Pharmacist",
    "certification_date": "2023-07-28",
    "enumeration_date": "2019-01-09",
    "last_updated": "2023-10-27",
    "organization_name": "TIOGA PHARMACY LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "5101 SHREVEPORT HWY",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PINEVILLE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "71360",
      "state": "LA",
      "telephone_number": "318-717-8555"
    },
    {
      "address_1": "685 ROBERTSON RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "POLLOCK",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "714673809",
      "state": "LA",
      "telephone_number": "318-769-9751"
    }
  ],
  "taxonomies": [
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}