{
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"EIN": null,
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"IsOrgSubpart": "Y",
"ParentOrgLBN": "HOMECARE CONCEPTS INC",
"ParentOrgTIN": null,
"OrgName": "HOMECARE CONCEPTS PHARMACY",
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "1095 ROUTE 110",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "FARMINGDALE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11735-4815",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-752-0555",
"MailingAddressFaxNumber": "631-752-8041",
"FirstLinePracticeLocationAddress": "226 MAIN ST",
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"PracticeLocationAddressCityName": "FARMINGDALE",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-752-0555",
"PracticeLocationAddressFaxNumber": "631-752-8040",
"EnumerationDate": "07/31/2008",
"LastUpdateDate": "07/31/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RYAN",
"AuthorizedOfficialFirstName": "THOMAS",
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"AuthorizedOfficialTitle": "PRESIDENT/CEO",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "631-752-0555",
"Taxonomies": {
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"TaxonomyName": "Pharmacy",
"LicenseNumber": "025345",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}