{
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"OrgName": "MIFFLIN COUNTY COMMUNITY SURGICAL CENTER PC",
"LastName": null,
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"FirstLineMailingAddress": "27 SANDY LN STE 220",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEWISTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "17044-1320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "717-242-4805",
"MailingAddressFaxNumber": "717-242-5900",
"FirstLinePracticeLocationAddress": "311 4TH ST",
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"PracticeLocationAddressCityName": "LEWISTOWN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "717-242-9565",
"PracticeLocationAddressFaxNumber": "717-242-9510",
"EnumerationDate": "03/28/2007",
"LastUpdateDate": "11/16/2011",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GORDON",
"AuthorizedOfficialFirstName": "ALAN",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "717-242-2514",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "10611500-PII",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}