{
"Npi": {
"NPI": "1275894123",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WHEELERS CUSTOM COMPOUNDING INC",
"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": "327 ROMANY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEXINGTON",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40502-2403",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "859-554-2716",
"MailingAddressFaxNumber": "859-554-0513",
"FirstLinePracticeLocationAddress": "327 ROMANY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEXINGTON",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40502-2403",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "859-554-2716",
"PracticeLocationAddressFaxNumber": "859-554-0513",
"EnumerationDate": "06/06/2012",
"LastUpdateDate": "12/21/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEWIS",
"AuthorizedOfficialFirstName": "CLAIRE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHARMACIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "859-396-6244",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0004X",
"TaxonomyName": "Compounding Pharmacy",
"LicenseNumber": "P07527",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}