{
"Npi": {
"NPI": "1720773419",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TAP PHARMACY, INC.",
"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": "11801 PIERCE ST UNIT 279",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERSIDE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92505-4408",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-946-6624",
"MailingAddressFaxNumber": "951-710-3147",
"FirstLinePracticeLocationAddress": "601 W 6TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CORONA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92882-3210",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-406-1521",
"PracticeLocationAddressFaxNumber": "951-406-1520",
"EnumerationDate": "04/07/2023",
"LastUpdateDate": "04/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "PHUONG",
"AuthorizedOfficialMiddleName": "MINH",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "714-299-5998",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}