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1972794816 NPI number — PLYMOUTH TOWNE CARE PHARMACY INC

NPI Number: 1972794816
Health Care Provider/Practitioner: PLYMOUTH TOWNE CARE PHARMACY INC

Information about “1972794816” NPI (PLYMOUTH TOWNE CARE PHARMACY INC) exists in 1972794816 in HTML format HTML  |  1972794816 in plain Text format TXT  |  1972794816 in PDF (Portable Document Format) PDF  |  1972794816 in an XML format XML  formats.

NPI Number : 1972794816 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972794816",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PLYMOUTH TOWNE CARE PHARMACY 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": "2855 MILLER DR",
    "SecondLineMailingAddress": "STE 111",
    "MailingAddressCityName": "PLYMOUTH",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46563-8091",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2855 MILLER DR",
    "SecondLinePracticeLocationAddress": "STE 111",
    "PracticeLocationAddressCityName": "PLYMOUTH",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46563-8091",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "574-941-1067",
    "PracticeLocationAddressFaxNumber": "574-941-1076",
    "EnumerationDate": "08/06/2007",
    "LastUpdateDate": "09/13/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ORENDOR",
    "AuthorizedOfficialFirstName": "JAMES",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "574-930-3167",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "3336C0003X",
        "TaxonomyName": "Community/Retail Pharmacy",
        "LicenseNumber": "60006058A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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