{
"Npi": {
"NPI": "1023740958",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GLENDALE PHARMACY FRISCO LLC",
"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": "7447 HILLCREST RD STE 105A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRISCO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75035-6297",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-292-9571",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7447 HILLCREST RD STE 105A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FRISCO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75035-6297",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-292-9571",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/29/2022",
"LastUpdateDate": "06/29/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ABOGE",
"AuthorizedOfficialFirstName": "CLEMENT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "972-292-9693",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}