{
"Npi": {
"NPI": "1194020883",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILLIPS HEARING AID CENTER 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": "1101 HUDSON LN",
"SecondLineMailingAddress": "SUITE 1-C",
"MailingAddressCityName": "MONROE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "71201-6045",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "318-325-2363",
"MailingAddressFaxNumber": "318-325-2361",
"FirstLinePracticeLocationAddress": "1101 HUDSON LN",
"SecondLinePracticeLocationAddress": "SUITE 1-C",
"PracticeLocationAddressCityName": "MONROE",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "71201-6045",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-325-2363",
"PracticeLocationAddressFaxNumber": "318-325-2361",
"EnumerationDate": "01/11/2011",
"LastUpdateDate": "02/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COLLUM",
"AuthorizedOfficialFirstName": "LARRY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "318-325-2363",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "LA-680",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}