{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CHEYENNE PROFESSIONAL DRUG, INC",
"ParentOrgTIN": null,
"OrgName": "CHEYENNE PROFESSIONAL DRUG, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "111 N 4TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAYRE",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "73662-2917",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "580-928-2741",
"MailingAddressFaxNumber": "580-928-2743",
"FirstLinePracticeLocationAddress": "111 N 4TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAYRE",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "73662-2917",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "580-928-2741",
"PracticeLocationAddressFaxNumber": "580-928-2743",
"EnumerationDate": "01/14/2008",
"LastUpdateDate": "11/08/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAKEY",
"AuthorizedOfficialFirstName": "EDDIE",
"AuthorizedOfficialMiddleName": "TOM",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "I",
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "580-928-2741",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "761461",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}