{
"Npi": {
"NPI": "1588915482",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VALOR MEDICAL SUPPLIES, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "25 LOWELL ST",
"SecondLineMailingAddress": "STE 305",
"MailingAddressCityName": "MANCHESTER",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03101-1647",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "781-363-2085",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "10 FERRY ST",
"SecondLinePracticeLocationAddress": "STE 305",
"PracticeLocationAddressCityName": "CONCORD",
"PracticeLocationAddressStateName": "NH",
"PracticeLocationAddressPostalCode": "03301-5022",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "781-363-2085",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/02/2012",
"LastUpdateDate": "04/08/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BIRNBAUM",
"AuthorizedOfficialFirstName": "AARON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "781-363-2085",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}