{
  "npi": "1861585002",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "MICHAEL",
    "authorized_official_last_name": "HOBSON",
    "authorized_official_telephone_number": "8708673310",
    "authorized_official_title_or_position": "VP",
    "enumeration_date": "2006-10-02",
    "last_updated": "2025-09-11",
    "organization_name": "CITY DRUG AND SODA FOUNTAIN",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 865",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MOUNT IDA",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "719570865",
      "state": "AR"
    },
    {
      "address_1": "121 W S WEST STREET",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MOUNT IDA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "870-867-4848",
      "postal_code": "71957",
      "state": "AR",
      "telephone_number": "870-867-3310"
    }
  ],
  "taxonomies": [
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": "AR18598",
      "primary": false,
      "state": "AR",
      "taxonomy_group": ""
    },
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "332B00000X",
      "desc": "Durable Medical Equipment & Medical Supplies",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "54",
        "medicare_type": "Other Medical Supply Company"
      },
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "87[3]",
        "medicare_type": "All Other Suppliers"
      },
      {
        "medicare_code": "A2[9]",
        "medicare_type": "Intermediate Care Nursing Facility"
      },
      {
        "medicare_code": "A6",
        "medicare_type": "Medical Supply Company with Respiratory Therapist"
      },
      {
        "medicare_code": "A7",
        "medicare_type": "Department Store"
      },
      {
        "medicare_code": "A8",
        "medicare_type": "Grocery Store"
      },
      {
        "medicare_code": "B3",
        "medicare_type": "Medical supply company with pedorthic personnel"
      }
    ]
  }
}