{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "HILLRISE PHARMACY LLC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "7817 CHELTENHAM AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAVEROCK",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19038-7621",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-326-1877",
"MailingAddressFaxNumber": "267-335-3937",
"FirstLinePracticeLocationAddress": "4240 N BROAD ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-403-7300",
"PracticeLocationAddressFaxNumber": "267-335-3937",
"EnumerationDate": "05/14/2021",
"LastUpdateDate": "05/14/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BADEJOKO",
"AuthorizedOfficialFirstName": "OMOTAYO",
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"AuthorizedOfficialTelephoneNumber": "215-403-7300",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336H0001X",
"TaxonomyName": "Home Infusion Therapy Pharmacy",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
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}
]
},
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}
}