{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHFIRST LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4332 KISSENA BLVD APT 5E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLUSHING",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11355-2946",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-693-2902",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "186 EASTERN BLVD N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAGERSTOWN",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21740-5843",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-513-6059",
"PracticeLocationAddressFaxNumber": "240-513-6319",
"EnumerationDate": "02/07/2021",
"LastUpdateDate": "02/07/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PINNOJU",
"AuthorizedOfficialFirstName": "SHIVAKUMAR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SUPERVISING PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "301-693-2902",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}