{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "LIVINGSTON COMMUNITY HEALTH",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "600 B ST BLDG A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LIVINGSTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95334-9593",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-850-3500",
"MailingAddressFaxNumber": "209-850-3498",
"FirstLinePracticeLocationAddress": "600 B ST BLDG B ROOM 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LIVINGSTON",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-850-3620",
"PracticeLocationAddressFaxNumber": "209-850-3629",
"EnumerationDate": "07/03/2019",
"LastUpdateDate": "03/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ABASTA-CUMMINGS",
"AuthorizedOfficialFirstName": "LESLIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "209-850-3500",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}