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
12404 WARWICK BLVD, NEWPORT NEWS, VA 23606-3007
(757) 595-3524
(757) 595-3538
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
0201003437
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010065780
MEDICAID DME
VA
01
—
4832083
NABP
—
05
—
8512183
—
VA
Enumeration date
08/16/2006
Last updated
03/07/2023
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