{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REMKEM CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "836 FALLKIRK CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COPPELL",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75019-2078",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-793-3236",
"MailingAddressFaxNumber": "972-899-1184",
"FirstLinePracticeLocationAddress": "9037 GARLAND RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75218-3919",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-660-1603",
"PracticeLocationAddressFaxNumber": "214-660-1608",
"EnumerationDate": "11/16/2011",
"LastUpdateDate": "06/26/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "XUAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CORPORATE OFFICER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-660-1603",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "27745",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}