{
"Npi": {
"NPI": "1922040385",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WALDRICH, INC.",
"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": "13204 N MACARTHUR BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OKLAHOMA CITY",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73142-3019",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "405-721-8802",
"MailingAddressFaxNumber": "405-721-8166",
"FirstLinePracticeLocationAddress": "122 N BRYANT AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EDMOND",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73034-6303",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "405-341-4883",
"PracticeLocationAddressFaxNumber": "405-844-3297",
"EnumerationDate": "06/11/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KINNEY",
"AuthorizedOfficialFirstName": "CATHERINE",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "BILLING OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MISS",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "405-721-8802",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "4117",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}