{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "D.L. BAKER DRUG CO., INC.",
"LastName": null,
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"Credential": null,
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"FirstLineMailingAddress": "4307 E BROADWAY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH LITTLE ROCK",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-945-3264",
"MailingAddressFaxNumber": "501-945-6976",
"FirstLinePracticeLocationAddress": "4307 E BROADWAY ST",
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"PracticeLocationAddressCityName": "NORTH LITTLE ROCK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "501-945-3264",
"PracticeLocationAddressFaxNumber": "501-945-6976",
"EnumerationDate": "07/28/2006",
"LastUpdateDate": "06/23/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KASSISSIEH",
"AuthorizedOfficialFirstName": "RANDY",
"AuthorizedOfficialMiddleName": "ISSA",
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"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "501-945-3264",
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}