{
"Npi": {
"NPI": "1619120995",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FOSTORIA HOSPITAL ASSOCIATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherFirstName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "601 PARKWAY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FOSTORIA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44830-1592",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-435-1832",
"MailingAddressFaxNumber": "419-435-9511",
"FirstLinePracticeLocationAddress": "601 PARKWAY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FOSTORIA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44830-1592",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-435-1832",
"PracticeLocationAddressFaxNumber": "419-435-9511",
"EnumerationDate": "10/30/2008",
"LastUpdateDate": "10/30/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAKACKI",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT, FOSTORIA HOSPITAL ASSOC",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "41994366649",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "0164HSP",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}