{
"Npi": {
"NPI": "1215065594",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEADOR DRUG",
"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": "215 W ROGER MILLER BLVD",
"SecondLineMailingAddress": "P.O.BOX 90",
"MailingAddressCityName": "ERICK",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73645-0090",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-526-3311",
"MailingAddressFaxNumber": "580-526-3275",
"FirstLinePracticeLocationAddress": "215 W ROGER MILLER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ERICK",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73645-0090",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-526-3311",
"PracticeLocationAddressFaxNumber": "580-526-3275",
"EnumerationDate": "03/01/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MEADOR",
"AuthorizedOfficialFirstName": "WARREN",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.PH.",
"AuthorizedOfficialTelephoneNumber": "580-526-3311",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "35-2267",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}