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)
(704) 844-6524
Entity
Organization
Contact information
Practice address
19815 NORTH COVE RD., CORNELIUS, NC 28031
(704) 895-5075
(704) 844-6556
Mailing address
701 CRESTDALE RD., MATTHEWS, NC 28105
(704) 844-3100
(704) 844-6556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
07057
NC
3336C0003X
Community/Retail Pharmacy
Primary
07057
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0608975
—
NC
01
—
3435131
NABP
—
01
—
7703106
MEDICAID DME
—
Enumeration date
09/28/2006
Last updated
03/07/2023
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