Organization
HARRIS TEETER, LLC
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE WARD (MANAGER, PHARMACY ADMIN/AR)
70484466524
Entity
Organization
Contact information
Practice address
401 PISGAH CHURCH RD., GREENSBORO, NC 27455
(336) 286-9433
(704) 844-6556
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 844-3100
(704) 844-6556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
08386
NC
3336C0003X
Community/Retail Pharmacy
Primary
08386
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418098
—
NC
01
—
3435460
NABP
NC
01
—
7703983
MEDICAID DME
NC
Enumeration date
09/01/2006
Last updated
03/07/2023
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