Organization
HARRIS TEETER LLC
Active
Other names
HARRIS TEETER PHARMACY #463
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (LICENSING MANAGER)
(513) 762-1019
Entity
Organization
Contact information
Practice address
3575 BRIDGE RD, SUFFOLK, VA 23435-1800
(757) 947-0236
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/11/2018
Last updated
04/19/2018
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