DataQProviderModel

Data Q Provider Identifier

Name

Store Number

Physical Address Line 1

Physical Address Line 2

Physical Address City

Physical Address State Code

Physical Address Zip Code

Primary Phone Number

Primary Phone Number Extension

Location's Fax Number

Location's Email Address

Flag indicating whether location operates 24 hours

Location hours

Location open date

Location closure date

Mailing Address Street Line 1

Mailing Address Street Line 2

Mailing Address City

Mailing Address State Code

Mailing Address Zip Code

Contact Last Name

Contact First Name

Contact Middle Initial

Contact Title

Contact Email address

Contact Phone Number

Contact Phone Number Extension

Dispenser Class Code

Primary Provider Type Code

Secondary Provider Type Code

Tertiary Provider Type Code

Medicare ID

NPI

DEA

NCPDP ID Number

Federal Tax ID

Primary Relationship Code

Chain Code

Franchise Code

Deactivation Code

Reinstatement Code

Reinstatement Date