{
"Npi": {
"NPI": "1255586111",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFE GUARD 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": "208 RIVERVIEW DR.",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELMONT",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "26134",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-665-2346",
"MailingAddressFaxNumber": "304-665-9402",
"FirstLinePracticeLocationAddress": "105 DUNCAN ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARLINTON",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "24954",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-665-2346",
"PracticeLocationAddressFaxNumber": "304-665-9402",
"EnumerationDate": "11/19/2008",
"LastUpdateDate": "06/11/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHIVELY",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "304-665-2346",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}