Provider Demographics
NPI:1649231937
Name:JAMES & ASSOCIATES DBA PERSON STREET DISCOUNT PHARMACY
Entity Type:Organization
Organization Name:JAMES & ASSOCIATES DBA PERSON STREET DISCOUNT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.PRES./PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:MIKE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-833-2332
Mailing Address - Street 1:301 PACE ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1208
Mailing Address - Country:US
Mailing Address - Phone:919-833-2332
Mailing Address - Fax:919-833-2332
Practice Address - Street 1:301 PACE ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1208
Practice Address - Country:US
Practice Address - Phone:919-833-2332
Practice Address - Fax:919-833-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08142333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0920367Medicaid