{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "DAVID K & ELLEN SCHMITZ, INC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "700 S RIVER ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPOONER",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54801-9692",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "715-635-8785",
"MailingAddressFaxNumber": "715-635-2637",
"FirstLinePracticeLocationAddress": "700 S RIVER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPOONER",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54801-9692",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "715-635-8785",
"PracticeLocationAddressFaxNumber": "715-635-2637",
"EnumerationDate": "12/26/2006",
"LastUpdateDate": "01/12/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TELLEFSON",
"AuthorizedOfficialFirstName": "ANGELA",
"AuthorizedOfficialMiddleName": "KAY",
"AuthorizedOfficialTitle": "MANAGING PHARMACIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "7150",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}