{
"Npi": {
"NPI": "1326242710",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRESCRIPTION LENS, 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": "320 S CHURCH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JONESBORO",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72401-2912",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-972-1818",
"MailingAddressFaxNumber": "870-972-0356",
"FirstLinePracticeLocationAddress": "320 S CHURCH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JONESBORO",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72401-2912",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-972-1818",
"PracticeLocationAddressFaxNumber": "870-972-0356",
"EnumerationDate": "06/12/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ACEBO",
"AuthorizedOfficialFirstName": "RUSTY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ABOC",
"AuthorizedOfficialTelephoneNumber": "870-972-1818",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "25089",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}