{
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"FirstLineMailingAddress": "709 W OKLAHOMA AVE",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "709 W OKLAHOMA AVE",
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"PracticeLocationAddressTelephoneNumber": "414-481-8170",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/19/2025",
"LastUpdateDate": "12/19/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEYER",
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"AuthorizedOfficialTelephoneNumber": "414-232-4103",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}