{
"Npi": {
"NPI": "1871860320",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HAMILTON PHARMACY LLC",
"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": "915 S DORT HWY",
"SecondLineMailingAddress": "SUITE 2",
"MailingAddressCityName": "FLINT",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48503-2800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "810-239-2475",
"MailingAddressFaxNumber": "810-239-3067",
"FirstLinePracticeLocationAddress": "915 S DORT HWY",
"SecondLinePracticeLocationAddress": "SUITE 2",
"PracticeLocationAddressCityName": "FLINT",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48503-2800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "810-239-2475",
"PracticeLocationAddressFaxNumber": "810-239-3067",
"EnumerationDate": "11/29/2011",
"LastUpdateDate": "07/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YOUSSEF",
"AuthorizedOfficialFirstName": "BASSAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "810-230-8300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "5301009692",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}