{
"Npi": {
"NPI": "1578557765",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PROTO SCRIPT PHARMACUETICALS CORP",
"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": "PO BOX 2462",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANCHO CUCAMONGA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91729-2462",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-507-8758",
"MailingAddressFaxNumber": "888-819-9749",
"FirstLinePracticeLocationAddress": "337 N VINEYARD AVE STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ONTARIO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91764-4436",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "855-476-7679",
"PracticeLocationAddressFaxNumber": "909-542-3176",
"EnumerationDate": "09/02/2005",
"LastUpdateDate": "11/14/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RICO",
"AuthorizedOfficialFirstName": "MICHELLE",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "855-476-7679",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "48177",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}