{
"Npi": {
"NPI": "1770162331",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DETROIT HOOVER PHARMACY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4877 CATALINA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKE ORION",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48359-2434",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-354-5909",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11538 EAST SEVEN MILES ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DETROIT",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48234-4835",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-354-5909",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/02/2021",
"LastUpdateDate": "10/26/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AHMAD",
"AuthorizedOfficialFirstName": "USMAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "586-354-5909",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}