Organization
HARRIS TEETER, LLC
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE WARD (DIR PHARMACY ACCOUNTING)
(704) 844-6524
Entity
Organization
Contact information
Practice address
2120 E FIRETOWER RD., SUITE 101, GREENVILLE, NC 27858
(252) 355-3083
(252) 355-5722
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 544-3100
(704) 844-6556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
09464
NC
3336C0003X
Community/Retail Pharmacy
Primary
09464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0745994
—
NC
01
—
34-07764
NCPDP
—
01
—
7704574
MEDICARE DME
NC
Enumeration date
01/17/2007
Last updated
03/07/2023
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