Person Street Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12035 Issued in NC

Legal business name

PERSON STREET PHARMACY LLC

Doing business as

Person Street Pharmacy LLC

Practice address

702 N Person St
Raleigh, NC 27604-1216

Phone

(919) 832-6432

Fax

(919) 833-7581

NPI assigned

May 12, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wesley Waters, PHARM.D.NPI 1083788343

Title

Manager

Phone

(919) 832-6432

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Person Street Pharmacy LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wesley V Waters III, PHARM.D., RPH

  • Pharmacist
  • Pittsboro, NC
  • NPI 1083788343
  NPD Authorized official
• Maresa Rose Roney, PHARMD

  • Pharmacist
  • Raleigh, NC
  • NPI 1659785996
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1831500032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N PERSON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041216",
            "telephone_number": "919-832-6432",
            "fax_number": "919-833-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N PERSON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041216",
            "telephone_number": "919-832-6432",
            "fax_number": "919-833-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSON STREET PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "919-832-6432",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146929",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Person Street Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon Lynn Perry, RPH
• William Alexander Perry III, LCAS-A
• Marguerite Perryman Perryman
• Mahogany Persip
• Person First Counseling Services PLLC
• Person Street Pharmacy of Raleigh, Inc.
• Latoya Nicole Person, MS
• Maryam Person, ITFS
• Tyshay Person
• Matthew Persons, D.C.

• Community/Retail Pharmacy in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.