{"npi":"1366811630","type":"NPI-2","status":"active","name":{"display":"Kmg Pharmacy LLC","other":[],"organization_name":"KMG PHARMACY LLC","authorised_official":"Mahmoud Shaltaf"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0004X","description":"Compounding Pharmacy","primary":false,"state":null,"license":null},{"code":"333600000X","description":"Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"OH","license":"022532100"}]},"addresses":[{"purpose":"LOCATION","street_1":"846 E MAIN ST","city":"TROTWOOD","state":"OH","postal_code":"454262911","country_code":"US","phone":"9375294433","fax":"9377154447"},{"purpose":"MAILING","street_1":"846 E MAIN ST","city":"TROTWOOD","state":"OH","postal_code":"454262911","country_code":"US","phone":"9375294433","fax":"9377154447"}],"license":{"state":"OH","number":"022532100"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0146319","state":"OH","issuer":null},{"type_code":"01","label":"Other","value":"2152395","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2015-09-17","last_updated":"2024-08-17","_meta":{"source":"NPPES","snapshot_date":"2024-08-17","doc_url":"https://findmynpi.com/api"}}