{
"Npi": {
"NPI": "1922174770",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARE WELL PHARMACY & SURGICAL 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": "826 E TREMONT AVE",
"SecondLineMailingAddress": "BRONX",
"MailingAddressCityName": "BRONX",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10460-4146",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-294-7147",
"MailingAddressFaxNumber": "718-294-7146",
"FirstLinePracticeLocationAddress": "826 E TREMONT AVE",
"SecondLinePracticeLocationAddress": "BRONX",
"PracticeLocationAddressCityName": "BRONX",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10460-4146",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-294-7147",
"PracticeLocationAddressFaxNumber": "718-294-7146",
"EnumerationDate": "11/24/2006",
"LastUpdateDate": "02/13/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRIVEDI",
"AuthorizedOfficialFirstName": "SANJAY",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "SUPERVISING PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "718-294-7147",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "027372",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}