{
"Npi": {
"NPI": "1245978337",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "PRESCRYPTIVE PHARMACY & PATIENT SERVICES INC",
"ParentOrgTIN": null,
"OrgName": "PRESCRYPTIVE PHARMACY & PATIENT SERVICES 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": "2127 S HIGHWAY 97 STE 150",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDMOND",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97756-0320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "541-526-3565",
"MailingAddressFaxNumber": "866-922-4730",
"FirstLinePracticeLocationAddress": "2127 S HIGHWAY 97 STE 150",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "REDMOND",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97756-0320",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-413-9475",
"PracticeLocationAddressFaxNumber": "866-922-4730",
"EnumerationDate": "05/26/2022",
"LastUpdateDate": "02/01/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "LEVI",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD, RPH",
"AuthorizedOfficialTelephoneNumber": "541-526-3565",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336M0002X",
"TaxonomyName": "Mail Order Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}