{
"Npi": {
"NPI": "1528092756",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WAYNE KWIKSCRIPT, 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": "1251 COLUMBIA AVENUE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONTICELLO",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42633-1677",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-348-4455",
"MailingAddressFaxNumber": "606-348-4717",
"FirstLinePracticeLocationAddress": "1251 COLUMBIA AVENUE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MONTICELLO",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42633-1677",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-348-4455",
"PracticeLocationAddressFaxNumber": "606-348-4717",
"EnumerationDate": "07/11/2006",
"LastUpdateDate": "01/18/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREGORY",
"AuthorizedOfficialFirstName": "BETINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "606-348-4455",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "9001116400",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "P07238",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}