Healthcare Provider Details

I. General information

NPI: 1609525153
Provider Name (Legal Business Name): TSI OF RALEIGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SUNDAY DR STE 115
RALEIGH NC
27607-5173
US

IV. Provider business mailing address

1401 SUNDAY DR STE 115
RALEIGH NC
27607-5173
US

V. Phone/Fax

Practice location:
  • Phone: 919-307-1474
  • Fax:
Mailing address:
  • Phone: 919-307-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA MCDONALD
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 919-307-1474