Organization
HARRIS TEETER, INC.
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE WARD (MANAGER PHARMACY ACCOUNTING)
(704) 844-6524
Entity
Organization
Contact information
Practice address
10320 MAIN ST, FAIRFAX, VA 22030-2410
(703) 352-8148
(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
3336C0003X
Community/Retail Pharmacy
Primary
0201003773
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0929934
—
NC
01
—
34-35016
NABP
—
01
—
7703107
MEDICAID DME
—
Enumeration date
09/07/2006
Last updated
03/07/2023
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