{
"Npi": {
"NPI": "1841651866",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAM'S HEARING AID CENTER #6332",
"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": "1000 FRANKLIN MILLS CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHILADELPHIA",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19154-3115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "215-613-1201",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 FRANKLIN MILLS CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PHILADELPHIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19154-3115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "215-613-1201",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/18/2016",
"LastUpdateDate": "03/18/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FARYNA",
"AuthorizedOfficialFirstName": "ROBIN",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "HEARING INSTRUMENT SPECIALIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BC-HIS",
"AuthorizedOfficialTelephoneNumber": "215-613-1201",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "F03577",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}