{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ST. LUKE'S HOMESTAR SERVICES 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,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "77 S COMMERCE WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BETHLEHEM",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-419-7610",
"MailingAddressFaxNumber": "610-882-9105",
"FirstLinePracticeLocationAddress": "1200 WELSH RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH WALES",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19454-3771",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-529-6351",
"PracticeLocationAddressFaxNumber": "610-882-9105",
"EnumerationDate": "12/01/2010",
"LastUpdateDate": "12/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOROCH",
"AuthorizedOfficialFirstName": "KEITH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": "COO",
"AuthorizedOfficialTelephoneNumber": "610-419-7610",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "1000002573",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}