Organization
HARRIS TEETER 046
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARMEN MONTANTE (PHARMACY MANAGER)
(704) 599-8670
Entity
Organization
Contact information
Practice address
9641 BROOKDALE DR, CHARLOTTE, NC 28215-8706
(704) 599-8670
(704) 599-8498
Mailing address
9641 BROOKDALE DR, CHARLOTTE, NC 28215-8706
(704) 599-8670
(704) 599-8498
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14566
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0609767
—
NC
Enumeration date
05/19/2011
Last updated
05/19/2011
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