{
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"EIN": null,
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"ParentOrgLBN": null,
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"OrgName": "REDLERS LONG TERM CARE PHARMACY",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "317 DAKOTA DUNES BLVD",
"SecondLineMailingAddress": "STE A",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "605-235-1552",
"MailingAddressFaxNumber": "605-235-1554",
"FirstLinePracticeLocationAddress": "317 DAKOTA DUNES BLVD",
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"PracticeLocationAddressTelephoneNumber": "605-235-1552",
"PracticeLocationAddressFaxNumber": "605-235-1554",
"EnumerationDate": "12/22/2008",
"LastUpdateDate": "06/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REDLER",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "605-235-1552",
"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
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},
{
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"LicenseNumber": "3691",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}