{
"Npi": {
"NPI": "1730503517",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE PHARMACY STATION 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": "397 ROBINS RUN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURLINGTON",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53105-1073",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "262-763-6969",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 S PINE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURLINGTON",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53105-2235",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-763-8877",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2014",
"LastUpdateDate": "07/21/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPITZER",
"AuthorizedOfficialFirstName": "JARED",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "262-763-8877",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "324500000X",
"TaxonomyName": "Substance Abuse Rehabilitation Facility",
"LicenseNumber": "9158-40",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}