{
"Npi": {
"NPI": "1497134449",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FULL HEALTH PHARMACY",
"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": "637 NE 125TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33161-5503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-703-4652",
"MailingAddressFaxNumber": "786-703-8761",
"FirstLinePracticeLocationAddress": "637 NE 125TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33161-5503",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "786-703-4652",
"PracticeLocationAddressFaxNumber": "786-703-8761",
"EnumerationDate": "05/22/2015",
"LastUpdateDate": "05/22/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OSUJI",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "CHUKWUEMEKA",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM D",
"AuthorizedOfficialTelephoneNumber": "786-703-4652",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PH29121",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}