{
"Npi": {
"NPI": "1154631158",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "VETHELP MEDICAL SERVICES",
"ParentOrgTIN": null,
"OrgName": "TRIOVERSEAS VETERANS HEATHCARE PROVIDER",
"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": "TRI OVERSEAS VETERANS HEALTH CARE PROVIDER",
"SecondLineMailingAddress": "RM, 504 PHYSICIANS CENTER, DR. R. POTENCIANO",
"MailingAddressCityName": "MANDALUYONG CITY",
"MailingAddressStateName": "163 EPIFANIO DELOS SANTOS AVE.",
"MailingAddressPostalCode": "1550",
"MailingAddressCountryCode": "PH",
"MailingAddressTelephoneNumber": "927-650-0014",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "TRI OVERSEAS VETERANS HEALTH CARE PROVIDER",
"SecondLinePracticeLocationAddress": "RM, 504 PHYSICIANS CENTER, DR. R. POTENCIANO",
"PracticeLocationAddressCityName": "MANDALUYONG CITY",
"PracticeLocationAddressStateName": "163 EPIFANIO DELOS SANTOS AVE.",
"PracticeLocationAddressPostalCode": "1550",
"PracticeLocationAddressCountryCode": "PH",
"PracticeLocationAddressTelephoneNumber": "927-650-0014",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/10/2010",
"LastUpdateDate": "10/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BANTANG",
"AuthorizedOfficialFirstName": "RESENA",
"AuthorizedOfficialMiddleName": "MAYUGA",
"AuthorizedOfficialTitle": "NURSE-BILLER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "927-650-0014",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}