{
"Npi": {
"NPI": "1285143925",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PA GROUP 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": "11618 US HWY 19",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORT RICHEY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34668",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-819-8200",
"MailingAddressFaxNumber": "727-819-9100",
"FirstLinePracticeLocationAddress": "11618 US HWY 19",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT RICHEY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34668",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-819-8200",
"PracticeLocationAddressFaxNumber": "727-819-9100",
"EnumerationDate": "09/26/2017",
"LastUpdateDate": "01/31/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRAN",
"AuthorizedOfficialFirstName": "YVONNE",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "727-846-1300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH30818",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}