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
1804 CENTER PARK, ABERDEEN, NC 28315
(910) 692-3048
(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
09366
NC
3336C0003X
Community/Retail Pharmacy
Primary
09366
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0635632
—
NC
01
—
3406421
NABP
—
01
—
7704601
MEDICAID DME
—
Enumeration date
08/16/2006
Last updated
03/07/2023
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