{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "PHARTRUST",
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"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "P O BOX 70250",
"SecondLineMailingAddress": "SUITE 146",
"MailingAddressCityName": "SAN JUAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00936",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-764-2899",
"MailingAddressFaxNumber": "787-764-0663",
"FirstLinePracticeLocationAddress": "PARANA AVENUE",
"SecondLinePracticeLocationAddress": "RIO PIEDRAS HEIGHTS SHOPPING CENTER",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00926",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-764-2899",
"PracticeLocationAddressFaxNumber": "787-764-0663",
"EnumerationDate": "02/09/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REYES",
"AuthorizedOfficialFirstName": "EMILIO",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-764-2899",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "07-F-1936",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}