Organization
HARRIS TEETER LLC
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (PHARMACY LICENSING MANAGER)
(513) 762-1019
Entity
Organization
Contact information
Practice address
701 FRANCIS KING ST., GREENSBORO, NC 27410
(336) 834-8028
(704) 844-6556
Mailing address
PO BOX 2918, HUTCHINSON, KS 67504-2918
(620) 694-5550
(704) 844-6556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
08107
NC
3336C0003X
Community/Retail Pharmacy
Primary
08107
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417998
—
NC
01
—
3439999
NABP
—
01
—
7703710
MEDICAID DME
—
Enumeration date
08/31/2006
Last updated
07/02/2024
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