{
"Npi": {
"NPI": "1730443839",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KHM PHARMACEUTICAL INC",
"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": "232 CAJON ST",
"SecondLineMailingAddress": "STE A",
"MailingAddressCityName": "REDLANDS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92373-5216",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-792-4922",
"MailingAddressFaxNumber": "909-792-4822",
"FirstLinePracticeLocationAddress": "232 CAJON ST STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "REDLANDS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92373-5216",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-792-4922",
"PracticeLocationAddressFaxNumber": "909-792-4822",
"EnumerationDate": "07/03/2012",
"LastUpdateDate": "01/15/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAHFOUZ",
"AuthorizedOfficialFirstName": "KHALID",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER / PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "909-792-4922",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PHY51038",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}