{
"Npi": {
"NPI": "1699947614",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMACIA SAGRADO CORAZON EXPRESS",
"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": "URB SANTA MARIA 139",
"SecondLineMailingAddress": "CALLE PEDRO DE ACOSTA",
"MailingAddressCityName": "SABANA GRANDE",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00637",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-873-1182",
"MailingAddressFaxNumber": "787-873-1182",
"FirstLinePracticeLocationAddress": "ED DORA PAGANELLI LOCAL 2",
"SecondLinePracticeLocationAddress": "AVE VICENTE QUILINCHINI",
"PracticeLocationAddressCityName": "SABANA GRANDE",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00637",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-873-7676",
"PracticeLocationAddressFaxNumber": "787-873-7373",
"EnumerationDate": "03/31/2008",
"LastUpdateDate": "01/31/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIRANDA",
"AuthorizedOfficialFirstName": "ILIANETTE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "787-873-7676",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "20F3348",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}