Organization
PERSON STREET PHARMACY LLC
Active
Other names
Person Street Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY WATERS PHARM.D. (MANAGER)
(919) 832-6432
Entity
Organization
Contact information
Practice address
702 N PERSON ST, RALEIGH, NC 27604-1216
(919) 832-6432
(919) 833-7581
Mailing address
702 N PERSON ST, RALEIGH, NC 27604-1216
(919) 832-6432
(919) 833-7581
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
12035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146929
PK
—
Enumeration date
05/12/2014
Last updated
10/20/2016
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