{
"Npi": {
"NPI": "1114175932",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOKAB MEDICAL SUPPLY INC",
"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": "2130 N ARROWHEAD AVE",
"SecondLineMailingAddress": "103A",
"MailingAddressCityName": "SAN BERNARDINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92405-4023",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-804-4076",
"MailingAddressFaxNumber": "909-804-4078",
"FirstLinePracticeLocationAddress": "2130 N ARROWHEAD AVE",
"SecondLinePracticeLocationAddress": "103 A",
"PracticeLocationAddressCityName": "SAN BERNARDINO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92405-4023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-804-4076",
"PracticeLocationAddressFaxNumber": "909-804-4078",
"EnumerationDate": "09/04/2008",
"LastUpdateDate": "09/04/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OLAYINKA",
"AuthorizedOfficialFirstName": "OLUSOLA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "909-804-4076",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "33200000X",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}