# HARRIS TEETER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harris Teeter \#429
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801655725
- **Authorized official:** LYSETTE SEILHAMER (MANAGER OF LICENSING)
- **Authorized official phone:** (515) 762-1090

## Contact information

- **Practice address:** 163 SEA ISLAND PKWY, BEAUFORT, SC 29907-1504
- **Practice address phone:** (854) 846-8330
- **Practice address fax:** (843) 593-9219
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2024
- **Last updated:** 03/14/2024