{
"Npi": {
"NPI": "1033257167",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RONETCO SUPERMARKETS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1070 US HIGHWAY 46 STE 17",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEDGEWOOD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07852-9701",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-927-8300",
"MailingAddressFaxNumber": "973-927-4953",
"FirstLinePracticeLocationAddress": "80 US HIGHWAY 206 # 90",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STANHOPE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07874-3129",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-448-1232",
"PracticeLocationAddressFaxNumber": "973-448-2488",
"EnumerationDate": "02/01/2007",
"LastUpdateDate": "11/20/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FIGUEROA RIVERA",
"AuthorizedOfficialFirstName": "MELISSA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "THIRD PARTY ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "732-521-8448",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "RS005612",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}