{
"Npi": {
"NPI": "1689853970",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "TOTAL CARE DME AND SUPPLIES, L.L.C.",
"ParentOrgTIN": null,
"OrgName": "TOTAL CARE D.M.E AND SUPPLIES, L.L.C",
"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": "4650 S. HAMPTON RD. STE. 104",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75232-1058",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-330-4300",
"MailingAddressFaxNumber": "866-648-1924",
"FirstLinePracticeLocationAddress": "4650 S. HAMPTON RD.",
"SecondLinePracticeLocationAddress": "SUITE # 104",
"PracticeLocationAddressCityName": "DALLAS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75232-1058",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-330-4300",
"PracticeLocationAddressFaxNumber": "866-648-1924",
"EnumerationDate": "11/02/2007",
"LastUpdateDate": "09/12/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BLANDON",
"AuthorizedOfficialFirstName": "RUTH",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "ADM/OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-330-4300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "0098314",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}