{
"Npi": {
"NPI": "1144732330",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KALLENBACH DRUG 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": "121 CIRCLE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANCHESTER",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "52057-1303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "563-249-5679",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "111 S FRANKLIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANCHESTER",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "52057-2132",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "563-249-5679",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/29/2017",
"LastUpdateDate": "10/29/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KALLENBACH",
"AuthorizedOfficialFirstName": "JONATHAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "563-249-5679",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "1617",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}