{
"Npi": {
"NPI": "1598887648",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "BANNER HEALTH",
"ParentOrgTIN": null,
"OrgName": "BANNER DESERT OUTPATIENT PHARMACY",
"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": "1400 S DOBSON RD",
"SecondLineMailingAddress": "ATTN CARL LABBE RPH",
"MailingAddressCityName": "MESA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85202-4707",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-512-5772",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1432 S DOBSON RD",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "MESA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85202-4768",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-461-0490",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/06/2007",
"LastUpdateDate": "10/22/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LABBE",
"AuthorizedOfficialFirstName": "CARL",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "480-512-5772",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}