{
"Npi": {
"NPI": "1457999229",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CYREENE",
"ParentOrgTIN": null,
"OrgName": "CYREENE",
"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": "43944 SWIFT FOX DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CALIFORNIA",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20619-7136",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-481-9928",
"MailingAddressFaxNumber": "301-263-7925",
"FirstLinePracticeLocationAddress": "25805 POINT LOOKOUT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEONARDTOWN",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20650-2013",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-309-4101",
"PracticeLocationAddressFaxNumber": "240-309-4094",
"EnumerationDate": "12/12/2019",
"LastUpdateDate": "04/08/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AIDOO",
"AuthorizedOfficialFirstName": "DOMINIC",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/LEAD PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "301-481-9928",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}