=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649231937
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES & ASSOCIATES DBA PERSON STREET DISCOUNT PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 PACE ST
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27604-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-833-2332
-----------------------------------------------------
Fax | 919-833-2332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 301 PACE ST
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27604-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-833-2332
-----------------------------------------------------
Fax | 919-833-2332
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | V.PRES./PHARMACIST
-----------------------------------------------------
Name | MR. FORREST MIKE JAMES
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 919-833-2332
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 08142
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------