{
"Npi": {
"NPI": "1669815775",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNIVERSAL PHARMACY SERVICES",
"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": "35300 HIGHWAY 41",
"SecondLineMailingAddress": "STE 101",
"MailingAddressCityName": "COARSEGOLD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93614-8715",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-692-2479",
"MailingAddressFaxNumber": "888-224-2543",
"FirstLinePracticeLocationAddress": "35300 HIGHWAY 41",
"SecondLinePracticeLocationAddress": "STE 101",
"PracticeLocationAddressCityName": "COARSEGOLD",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93614-8715",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-692-2479",
"PracticeLocationAddressFaxNumber": "888-224-2543",
"EnumerationDate": "04/09/2013",
"LastUpdateDate": "03/05/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DRAPER",
"AuthorizedOfficialFirstName": "AARON",
"AuthorizedOfficialMiddleName": "WRIGHT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "559-307-4137",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}