{
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"IsOrgSubpart": "N",
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"OrgName": "DELTA DISCOUNT DRUGS INC.",
"LastName": null,
"FirstName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "731 S STATE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLARKSDALE",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38614-4801",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-624-5190",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "731 S STATE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLARKSDALE",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-624-5190",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/17/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "MARVIN",
"AuthorizedOfficialMiddleName": "CAREY",
"AuthorizedOfficialTitle": "PRESIDENTAL PHARMACIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "662-624-5190",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "02059/01.1",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}