{
"Npi": {
"NPI": "1902066319",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "METTESAVE DISCOUNT DRUGS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "595 HIGHWAY 6 E",
"SecondLineMailingAddress": "DME",
"MailingAddressCityName": "BATESVILLE",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38606-3003",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-563-4557",
"MailingAddressFaxNumber": "662-563-4294",
"FirstLinePracticeLocationAddress": "595 HIGHWAY 6 E",
"SecondLinePracticeLocationAddress": "DME",
"PracticeLocationAddressCityName": "BATESVILLE",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "38606-3003",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-563-4557",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/10/2008",
"LastUpdateDate": "12/10/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROOME",
"AuthorizedOfficialFirstName": "ERIK",
"AuthorizedOfficialMiddleName": "RAY",
"AuthorizedOfficialTitle": "PHARMACIST/MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "662-563-4557",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "00856",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}