{
"Npi": {
"NPI": "1841638608",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ADVANCED LABORATORY SERVICES, INC.",
"ParentOrgTIN": null,
"OrgName": "ADVANCED LABORATORY SERVICES, 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": "PO BOX 5312",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LUTHERVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21094-5312",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-864-8181",
"MailingAddressFaxNumber": "410-864-8149",
"FirstLinePracticeLocationAddress": "1498 REISTERSTOWN RD",
"SecondLinePracticeLocationAddress": "#207",
"PracticeLocationAddressCityName": "PIKESVILLE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21208-3817",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-864-8181",
"PracticeLocationAddressFaxNumber": "410-864-8149",
"EnumerationDate": "06/13/2013",
"LastUpdateDate": "08/09/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REID",
"AuthorizedOfficialFirstName": "MONIQUE",
"AuthorizedOfficialMiddleName": "N.",
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "410-864-8181",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "00000000",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}