{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LUXCARE 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": "2503 CAPITAL AVE SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATTLE CREEK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49015-4103",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-883-9900",
"MailingAddressFaxNumber": "269-883-9911",
"FirstLinePracticeLocationAddress": "2503 CAPITAL AVE SW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BATTLE CREEK",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49015-4103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "269-883-9900",
"PracticeLocationAddressFaxNumber": "269-883-9911",
"EnumerationDate": "08/14/2017",
"LastUpdateDate": "07/19/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAMAD",
"AuthorizedOfficialFirstName": "ALI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PIC/AO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "269-883-9900",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
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},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "5301011231",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}