{
"Npi": {
"NPI": "1255614038",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRISMA PHARMACY PLLC",
"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": "590 N ALMA SCHOOL RD",
"SecondLineMailingAddress": "STE 3",
"MailingAddressCityName": "CHANDLER",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85224-4361",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-719-8798",
"MailingAddressFaxNumber": "480-719-8795",
"FirstLinePracticeLocationAddress": "590 N ALMA SCHOOL RD",
"SecondLinePracticeLocationAddress": "STE 3",
"PracticeLocationAddressCityName": "CHANDLER",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85224-4361",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-719-8798",
"PracticeLocationAddressFaxNumber": "480-719-8795",
"EnumerationDate": "09/28/2011",
"LastUpdateDate": "04/04/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKPAN",
"AuthorizedOfficialFirstName": "IBORO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PIC/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "480-577-8726",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": "Y005421",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}