{
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"FirstLineMailingAddress": "3104 CASCADE ST",
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"MailingAddressCityName": "JONESBORO",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72404-9014",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "112 FRONT STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAYLOR",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/06/2026",
"LastUpdateDate": "08/06/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILKINS",
"AuthorizedOfficialFirstName": "PHILLIP",
"AuthorizedOfficialMiddleName": "KEITH",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "573-276-3784",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}