{
  "npi": "1619358967",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "ESTHER",
    "authorized_official_last_name": "NJIBAMUM",
    "authorized_official_telephone_number": "7135851642",
    "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
    "enumeration_date": "2015-06-12",
    "last_updated": "2015-07-10",
    "organization_name": "3D&S SUPREME PHARMACY",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "203 E DAVIS ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CONROE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "936-494-3784",
      "postal_code": "773013159",
      "state": "TX",
      "telephone_number": "936-494-3781"
    },
    {
      "address_1": "203 E DAVIS ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CONROE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "936-494-3784",
      "postal_code": "773013159",
      "state": "TX",
      "telephone_number": "936-494-3781"
    }
  ],
  "taxonomies": [
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": "29914",
      "primary": true,
      "state": "TX",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}