{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAKSHMI PHARMACY ENTERPRISES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "3514 PINE ESTATES DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST BLOOMFIELD",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48323-1954",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-202-0600",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4600 INVESTMENT DR",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "TROY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48098-6365",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-312-0037",
"PracticeLocationAddressFaxNumber": "248-792-2544",
"EnumerationDate": "11/11/2010",
"LastUpdateDate": "03/22/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NANDI",
"AuthorizedOfficialFirstName": "PARTHA",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "586-202-0600",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "5301009453",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}