{
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"NPI": "1932481629",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SKYLINE EMS INC.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "310 E MAIN AVE STE 213",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78573-6872",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-240-4448",
"MailingAddressFaxNumber": "267-381-4496",
"FirstLinePracticeLocationAddress": "1908 S MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MCALLEN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78503-5414",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-240-4448",
"PracticeLocationAddressFaxNumber": "267-381-4496",
"EnumerationDate": "09/19/2011",
"LastUpdateDate": "01/23/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORDERO",
"AuthorizedOfficialFirstName": "JUAN",
"AuthorizedOfficialMiddleName": "FRANCISCO",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "ECA",
"AuthorizedOfficialTelephoneNumber": "956-240-4448",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "1000723",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}