Organization
HARRIS TEETER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY NOBLITT (LICENSE ADMINISTRATOR)
(704) 844-3418
Entity
Organization
Contact information
Practice address
2120 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-1722
(919) 731-2423
(919) 731-9918
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 844-3418
(704) 844-6512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/13/2013
Last updated
08/11/2014
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