{
"Npi": {
"NPI": "1801589734",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HICARE PHARMACY 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": "4140 SALEM AVE STE 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DAYTON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45416-1703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-723-6034",
"MailingAddressFaxNumber": "937-723-6415",
"FirstLinePracticeLocationAddress": "8769 N MAIN ST FL 1",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DAYTON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45415-1392",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-723-6034",
"PracticeLocationAddressFaxNumber": "937-723-3641",
"EnumerationDate": "05/26/2023",
"LastUpdateDate": "05/19/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DWOMOH",
"AuthorizedOfficialFirstName": "SAMUEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CO- OWNER/PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "513-223-9262",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}