{
"Npi": {
"NPI": "1194929646",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ST. VINCENT HOSPITAL & HEALTH CARE CENTER, INC.",
"ParentOrgTIN": null,
"OrgName": "ST. VINCENT HOSPITAL & HEALTH CARE 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": "2001 W 86TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INDIANAPOLIS",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46260-1902",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "317-338-3950",
"MailingAddressFaxNumber": "317-338-9837",
"FirstLinePracticeLocationAddress": "2001 W 86TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDIANAPOLIS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46260-1902",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-338-3950",
"PracticeLocationAddressFaxNumber": "317-338-9837",
"EnumerationDate": "06/11/2007",
"LastUpdateDate": "06/29/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEMASTERS",
"AuthorizedOfficialFirstName": "WENDY",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "AMBULATORY MANAGER PHARMACY SERVICE",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D.",
"AuthorizedOfficialTelephoneNumber": "317-338-2097",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "60005959A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}