{
"Npi": {
"NPI": "1932261658",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DANNY B DEDMON",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 S MILL AVE",
"SecondLineMailingAddress": "P O DRAWER C",
"MailingAddressCityName": "DYERSBURG",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38024-4636",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "731-285-7284",
"MailingAddressFaxNumber": "731-285-8959",
"FirstLinePracticeLocationAddress": "101 S MILL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DYERSBURG",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "38024-4636",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "731-285-7284",
"PracticeLocationAddressFaxNumber": "731-285-8959",
"EnumerationDate": "12/16/2006",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEDMON",
"AuthorizedOfficialFirstName": "DANNY",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "OWNER-PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.PH",
"AuthorizedOfficialTelephoneNumber": "731-285-7284",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}