{
"Npi": {
"NPI": "1699070425",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LINCOURT COMPOUNDING CENTER",
"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": "501 S LINCOLN AVE",
"SecondLineMailingAddress": "SUITE 23",
"MailingAddressCityName": "CLEARWATER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33756-5945",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-479-3046",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "501 S LINCOLN AVE",
"SecondLinePracticeLocationAddress": "SUITE 23",
"PracticeLocationAddressCityName": "CLEARWATER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33756-5945",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-479-3046",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2011",
"LastUpdateDate": "01/26/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LADSON",
"AuthorizedOfficialFirstName": "LOUIS",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH",
"AuthorizedOfficialTelephoneNumber": "727-479-3046",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0004X",
"TaxonomyName": "Compounding Pharmacy",
"LicenseNumber": "PH24418",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}