{
"Npi": {
"NPI": "1780072116",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ACS MEDICAL LLC",
"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": "10538 JUSTIN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "URBANDALE",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50322-3755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-421-4933",
"MailingAddressFaxNumber": "515-331-9038",
"FirstLinePracticeLocationAddress": "10538 JUSTIN DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "URBANDALE",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50322-3755",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-421-4933",
"PracticeLocationAddressFaxNumber": "515-331-9038",
"EnumerationDate": "01/08/2015",
"LastUpdateDate": "01/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COAKLEY",
"AuthorizedOfficialFirstName": "GREGG",
"AuthorizedOfficialMiddleName": "JAMES",
"AuthorizedOfficialTitle": "MEMBER/MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "515-421-4933",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BX2000X",
"TaxonomyName": "Oxygen Equipment & Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}