{"npi":"1770146367","type":"NPI-2","status":"active","name":{"display":"Medly Pharmacy PA Inc.","other":[],"organization_name":"MEDLY PHARMACY PA INC.","authorised_official":"Alison Farrell"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1222 WALNUT ST","city":"PHILADELPHIA","state":"PA","postal_code":"191075466","country_code":"US","phone":"2159416240","fax":"2159416244"},{"purpose":"MAILING","street_1":"104 GRAHAM AVE","city":"BROOKLYN","state":"NY","postal_code":"112063320","country_code":"US"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"PP482489","state":"PA","issuer":"PHARMACY LICENSE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20220406003073","type_code":"12-73","type_desc":"PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)","state":"PA","pac_id":"2567793102"}]},"enumeration_date":"2019-04-18","last_updated":"2022-05-20","_meta":{"source":"NPPES","snapshot_date":"2022-05-20","doc_url":"https://findmynpi.com/api"}}