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1902135130 NPI number — 5 STAR ORIENTAL MEDICINE

NPI Number: 1902135130
Health Care Provider/Practitioner: 5 STAR ORIENTAL MEDICINE

Information about “1902135130” NPI (5 STAR ORIENTAL MEDICINE) exists in 1902135130 in HTML format HTML  |  1902135130 in plain Text format TXT  |  1902135130 in PDF (Portable Document Format) PDF  |  1902135130 in an XML format XML  formats.

NPI Number : 1902135130 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902135130",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "5 STAR ORIENTAL MEDICINE",
    "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": "PO BOX 1460",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MATHEWS",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23109-1460",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-725-9001",
    "MailingAddressFaxNumber": "804-725-9005",
    "FirstLinePracticeLocationAddress": "28 CHURCH STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MATHEWS",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23109",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-725-9001",
    "PracticeLocationAddressFaxNumber": "804-725-9005",
    "EnumerationDate": "12/17/2009",
    "LastUpdateDate": "05/24/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "STEWART",
    "AuthorizedOfficialFirstName": "AUDREY",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "L.AC.",
    "AuthorizedOfficialTelephoneNumber": "804-725-9001",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261Q00000X",
        "TaxonomyName": "Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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