{
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"EIN": null,
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"IsOrgSubpart": "Y",
"ParentOrgLBN": "NORTH DAKOTA STATE UNIVERSITY",
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"OrgName": "COLLEGE OF PHARMACY, NURSING, AND ALLIED SCIENCES",
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"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1301 12TH AVE N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARGO",
"MailingAddressStateName": "ND",
"MailingAddressPostalCode": "58105-5055",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "701-231-6469",
"MailingAddressFaxNumber": "701-231-7606",
"FirstLinePracticeLocationAddress": "1301 12TH AVE N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FARGO",
"PracticeLocationAddressStateName": "ND",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "701-231-7609",
"PracticeLocationAddressFaxNumber": "701-231-7606",
"EnumerationDate": "07/10/2008",
"LastUpdateDate": "07/10/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PETERSON",
"AuthorizedOfficialFirstName": "CHARLES",
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"AuthorizedOfficialTitle": "DEAN",
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"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "701-231-7609",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pharmacy",
"LicenseNumber": "166",
"LicenseNumberStateCode": "ND",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}