{
"Npi": {
"NPI": "1497216352",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CLEVELAND PHARMACY INC",
"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": "483 E ALMOND AVE STE 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MADERA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93637-5748",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-395-4127",
"MailingAddressFaxNumber": "559-517-3646",
"FirstLinePracticeLocationAddress": "483 E ALMOND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MADERA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93637-5747",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-395-4127",
"PracticeLocationAddressFaxNumber": "559-517-3646",
"EnumerationDate": "03/25/2019",
"LastUpdateDate": "04/04/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ELSAYED",
"AuthorizedOfficialFirstName": "MOHAMED",
"AuthorizedOfficialMiddleName": "ELSAYEED AHMED",
"AuthorizedOfficialTitle": "PRESIDENT/PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "559-395-4127",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}