{
"Npi": {
"NPI": "1164791539",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TLH ENTERPRISES 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": "41120 WASHINGTON ST STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BERMUDA DUNES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92203-9596",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-360-3339",
"MailingAddressFaxNumber": "760-345-4800",
"FirstLinePracticeLocationAddress": "41120 WASHINGTON ST STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BERMUDA DUNES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92203-9596",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-360-3339",
"PracticeLocationAddressFaxNumber": "760-345-4800",
"EnumerationDate": "12/14/2011",
"LastUpdateDate": "01/26/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NYMAN",
"AuthorizedOfficialFirstName": "ALLAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SECRETARY/PHARMACIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "760-360-3339",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PHY50770",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}