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Organization

HARRIS TEETER, LLC

Active
Other names
Harris Teeter Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization

Contact information

Practice address
4701 SMITH FARM RD, CHARLOTTE, NC 28216
(704) 949-2211
(980) 256-3442
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
07267
NC
3336C0003X
Community/Retail Pharmacy
Primary
07267
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0609159
NC
01
3436347
NABP
01
7703250
MEDICAID DME
Enumeration date
09/08/2006
Last updated
03/07/2023
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