{
"Npi": {
"NPI": "1497363741",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHARMESTATE LLC",
"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": "317 CENTRAL EXPRESSWAY NORTH",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALLEN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75013",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-390-9888",
"MailingAddressFaxNumber": "972-390-9889",
"FirstLinePracticeLocationAddress": "317 CENTRAL EXPRESSWAY NORTH",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALLEN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75013",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-390-9888",
"PracticeLocationAddressFaxNumber": "972-390-9889",
"EnumerationDate": "07/22/2020",
"LastUpdateDate": "11/03/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOMUVES",
"AuthorizedOfficialFirstName": "ANDREW",
"AuthorizedOfficialMiddleName": "JOHN",
"AuthorizedOfficialTitle": "PHARMACIST IN CHARGE/ CO-OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "R. PH.",
"AuthorizedOfficialTelephoneNumber": "972-390-9888",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}