{
"Npi": {
"NPI": "1003174152",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DURAMAX MEDICAL SUPPLY, INC.",
"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": "9427 CONANT ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "HAMTRAMCK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48212-3689",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-601-9618",
"MailingAddressFaxNumber": "860-631-9618",
"FirstLinePracticeLocationAddress": "9427 CONANT ST",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "HAMTRAMCK",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48212-3689",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-601-9618",
"PracticeLocationAddressFaxNumber": "860-631-9618",
"EnumerationDate": "04/26/2012",
"LastUpdateDate": "03/13/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "MELISSA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "586-601-9618",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}