{
"Npi": {
"NPI": "1790926368",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CONFIDENTIAL PHARMACEUTICAL SERVICES, LLC.",
"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": "2087 QUAKER POINTE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "QUAKERTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18951-2164",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "267-373-9087",
"MailingAddressFaxNumber": "267-373-9087",
"FirstLinePracticeLocationAddress": "2087 QUAKER POINTE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "QUAKERTOWN",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18951-2164",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "267-373-9087",
"PracticeLocationAddressFaxNumber": "267-373-9087",
"EnumerationDate": "03/11/2009",
"LastUpdateDate": "03/11/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DERSHEM",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "267-373-9087",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336M0002X",
"TaxonomyName": "Mail Order Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}