{
"Npi": {
"NPI": "1164634952",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL",
"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": "6340 QUADRANGLE DRIVE",
"SecondLineMailingAddress": "SUITE 170",
"MailingAddressCityName": "CHAPEL HILL",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27517-8077",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-843-9255",
"MailingAddressFaxNumber": "919-843-9210",
"FirstLinePracticeLocationAddress": "6340 QUADRANGLE DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 170",
"PracticeLocationAddressCityName": "CHAPEL HILL",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27517-8077",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-843-9255",
"PracticeLocationAddressFaxNumber": "919-843-9210",
"EnumerationDate": "05/04/2007",
"LastUpdateDate": "06/08/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WITTES",
"AuthorizedOfficialFirstName": "JASON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF PHARMACY PROGRAMS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "919-843-9255",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": "10016",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}