{
"Npi": {
"NPI": "1144283938",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ATENDA SPECIALTY INFUSION PHARMACY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15712 SW 41ST ST",
"SecondLineMailingAddress": "SUITE 16",
"MailingAddressCityName": "DAVIE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33331-1538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-217-6055",
"MailingAddressFaxNumber": "954-217-6062",
"FirstLinePracticeLocationAddress": "15712 SW 41ST ST",
"SecondLinePracticeLocationAddress": "SUITE 16",
"PracticeLocationAddressCityName": "DAVIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33331-1538",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-217-6055",
"PracticeLocationAddressFaxNumber": "954-217-6062",
"EnumerationDate": "04/11/2006",
"LastUpdateDate": "04/15/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODGERS",
"AuthorizedOfficialFirstName": "CHERI",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR - AHS",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "954-217-6055",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PH13111",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}