{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MEDI-K INC",
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"NamePrefix": null,
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"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2202 HWY 250 N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KINSTON",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28504",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-522-2200",
"MailingAddressFaxNumber": "252-522-2202",
"FirstLinePracticeLocationAddress": "2202 US HIGHWAY 258N",
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"PracticeLocationAddressCityName": "KINSTON",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28504-7223",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-522-2200",
"PracticeLocationAddressFaxNumber": "252-522-2202",
"EnumerationDate": "06/18/2012",
"LastUpdateDate": "02/24/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANGE",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "252-522-0353",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "11293",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}