{
"Npi": {
"NPI": "1992104624",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRIME RX PHARMACY",
"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": "3001 CANIFF ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAMTRAMCK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48212-3018",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-305-4192",
"MailingAddressFaxNumber": "313-305-4219",
"FirstLinePracticeLocationAddress": "3001 CANIFF ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAMTRAMCK",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48212-3018",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "313-305-4192",
"PracticeLocationAddressFaxNumber": "313-305-4219",
"EnumerationDate": "08/19/2014",
"LastUpdateDate": "10/21/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHOWDHURY",
"AuthorizedOfficialFirstName": "AFSANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "313-353-9257",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "5301010551",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}