Organization
HARRIS TEETER LLC
Active
Other names
Harris Teeter Pharmacy #419
Organization subpart
No
Provider details
NPI number
Authorized official
MARY NOBLITT (LICENSE ADMINISTRATOR)
(704) 844-3418
Entity
Organization
Contact information
Practice address
2105 PRINCESS ANNE ROAD, SUITE 100, VIRGINIA BEACH, VA 23456
(757) 721-2672
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 844-3418
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/23/2014
Last updated
07/22/2015
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