{
"Npi": {
"NPI": "1114052198",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FALLON TRIBAL HEALTH CENTER",
"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": "1001 RIO VISTA ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FALLON",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89406-5463",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "775-423-3634",
"MailingAddressFaxNumber": "775-423-7319",
"FirstLinePracticeLocationAddress": "1001 RIO VISTA ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FALLON",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89406-5463",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "775-423-3634",
"PracticeLocationAddressFaxNumber": "775-423-7319",
"EnumerationDate": "02/22/2007",
"LastUpdateDate": "03/12/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "11/02/2021",
"NPIReactivationDate": "03/12/2026",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YODER",
"AuthorizedOfficialFirstName": "SHERRI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACY DIRECOT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "775-423-3634",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332800000X",
"TaxonomyName": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}