PERSON STREET PHARMACY OF RALEIGH, INC. - NPI 1053372342

Q: What is Person Street Pharmacy Of Raleigh, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

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About Person Street Pharmacy Of Raleigh, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERSON STREET PHARMACY OF RALEIGH, INC. (NPI 1053372342) is a healthcare organization registered as a pharmacy in Raleigh, North Carolina and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through March 29, 2028 and lists Forrest Mike James, President/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1053372342

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NamePERSON STREET PHARMACY OF RALEIGH, INC.

Location Address702 N PERSON STRaleigh, NC 27604-1216

Mailing Address702 N Person StRaleigh, NC 27604-1216 · (919) 832-6432 · Fax (919) 833-7581

Phone(919) 832-6432

Fax(919) 833-7581

Organization SubpartNo

Authorized OfficialForrest Mike JamesPresident/pharmacist · (919) 832-6432

Enumeration DateMarch 28, 2006

Last NPPES UpdateSeptember 23, 2008

✔ NPI 1053372342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in NC · 03305

Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

702 N PERSON ST, Raleigh, NC 27604

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Other Identifiers 2

Medicaid0925149NC

Medicare ID-Type Unspecified0516710001NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2181233

Person Street Pharmacy · Raleigh, NC

Active · expires Mar 29, 2028

CLIA Number34D2181233

Laboratory TypePharmacy

Certificate Effective DateMarch 30, 2026

Certificate Expiration DateMarch 29, 2028

Laboratory DirectorMaresa Rose Roney

Laboratory Phone(919) 832-6432

Laboratory LocationPerson Street Pharmacy702 N Person Street, Raleigh, NC 27604

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE BALDWIN DANIEL RPH

Pharmacist