{
"Npi": {
"NPI": "1053402867",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUTTONS DRUG 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": "12101 JOSEPH CAMPAU ST",
"SecondLineMailingAddress": "STE 1",
"MailingAddressCityName": "HAMTRAMCK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48212-2590",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "313-305-4746",
"MailingAddressFaxNumber": "313-305-4759",
"FirstLinePracticeLocationAddress": "12101 JOSEPH CAMPAU ST",
"SecondLinePracticeLocationAddress": "STE 1",
"PracticeLocationAddressCityName": "HAMTRAMCK",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48212-2590",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "313-305-4746",
"PracticeLocationAddressFaxNumber": "313-305-4759",
"EnumerationDate": "09/27/2006",
"LastUpdateDate": "01/19/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALKHATEEB",
"AuthorizedOfficialFirstName": "THAMER",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "CEO/PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "313-722-0162",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "5301007363",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}