{
"Npi": {
"NPI": "1326465931",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COLORADO WEST HEALTHCARE SYSTEM",
"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": "2373 G RD",
"SecondLineMailingAddress": "SUITE 120",
"MailingAddressCityName": "GRAND JUNCTION",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81505-9641",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-644-4380",
"MailingAddressFaxNumber": "970-644-4394",
"FirstLinePracticeLocationAddress": "2373 G RD",
"SecondLinePracticeLocationAddress": "SUITE 120",
"PracticeLocationAddressCityName": "GRAND JUNCTION",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81505-9641",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-644-4380",
"PracticeLocationAddressFaxNumber": "970-644-4394",
"EnumerationDate": "03/20/2014",
"LastUpdateDate": "05/07/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VEJRASKA",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "DIRECTOR OF RETAIL PHARMACIES",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM.D., M.S.",
"AuthorizedOfficialTelephoneNumber": "970-243-3400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "1680000055",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}