{
"Npi": {
"NPI": "1134233166",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PACE MOBILITY PRODUCTS",
"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": "2040 MADISON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COVINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41014-0008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-525-6623",
"MailingAddressFaxNumber": "859-525-6757",
"FirstLinePracticeLocationAddress": "2040 MADISON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COVINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41014-0008",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-525-6623",
"PracticeLocationAddressFaxNumber": "859-525-6757",
"EnumerationDate": "08/18/2006",
"LastUpdateDate": "07/31/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PACE",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "ALBERT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "859-525-6623",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "13008",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}