{"npi":"1225116239","type":"NPI-2","status":"active","name":{"display":"Crystal Pharmacy LLC","other":[],"organization_name":"CRYSTAL PHARMACY LLC","authorised_official":"Scotty Jarvis"},"specialty":{"primary_taxonomy":"183500000X","primary_taxonomy_description":"Pharmacist","slug":"pharmacist","schema_org_specialty":null,"all":[{"code":"183500000X","description":"Pharmacist","primary":true,"state":"GA","license":"2206"}]},"addresses":[{"purpose":"LOCATION","street_1":"705 SOUTH MAIN ST","city":"MOULTRIE","state":"GA","postal_code":"31768","country_code":"US","phone":"2299854137","fax":"2298905968"},{"purpose":"MAILING","street_1":"PO BOX 8","city":"MOULTRIE","state":"GA","postal_code":"317760008","country_code":"US","phone":"2299854137","fax":"2298905968"}],"license":{"state":"GA","number":"2206"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00025605A","state":"GA","issuer":null},{"type_code":"01","label":"Other","value":"1101942","state":null,"issuer":"NABP"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-11-01","last_updated":"2023-03-07","_meta":{"source":"NPPES","snapshot_date":"2023-03-07","doc_url":"https://findmynpi.com/api"}}