Organization
HARRIS TEETER, LLC
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE WARD (MANAGER, PHARMACY ACCOUNTING)
(704) 844-6534
Entity
Organization
Contact information
Practice address
3333 VIRGINIA BCH BLVD. #101, VIRGINIA BEACH, VA 23452
(757) 631-2415
(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
0201003968
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010074631
MEDICAID DME
—
05
—
10061831
—
VA
01
—
48-38061
NABP
—
Enumeration date
09/08/2006
Last updated
03/07/2023
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