{
"Npi": {
"NPI": "1972667046",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SOUTH OGDEN CITY CORPORATION",
"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": "3950 ADAMS AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH OGDEN",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84403-1822",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-622-2753",
"MailingAddressFaxNumber": "801-622-2755",
"FirstLinePracticeLocationAddress": "3950 ADAMS AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTH OGDEN",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84403-1822",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-622-2753",
"PracticeLocationAddressFaxNumber": "801-622-2755",
"EnumerationDate": "12/21/2006",
"LastUpdateDate": "12/29/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STOREY",
"AuthorizedOfficialFirstName": "BRANDON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DEPUTY FIRE CHIEF",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "801-622-2750",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "2930L",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}