{
"Npi": {
"NPI": "1902451552",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SISU HEALTHCARE SOLUTIONS, INC.",
"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": "914 S 52ND ST STE 110",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TEMPE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85281-9500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-999-4488",
"MailingAddressFaxNumber": "480-999-4488",
"FirstLinePracticeLocationAddress": "914 S 52ND ST STE 110",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEMPE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85281-9500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-999-4488",
"PracticeLocationAddressFaxNumber": "480-999-4488",
"EnumerationDate": "08/09/2019",
"LastUpdateDate": "07/14/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ULM",
"AuthorizedOfficialFirstName": "MARCUS",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "702-577-1617",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251F00000X",
"TaxonomyName": "Home Infusion Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QI0500X",
"TaxonomyName": "Infusion Therapy Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0002X",
"TaxonomyName": "Clinic Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0004X",
"TaxonomyName": "Compounding Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336H0001X",
"TaxonomyName": "Home Infusion Therapy Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332BP3500X",
"TaxonomyName": "Parenteral & Enteral Nutrition Supplies (DME)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}