Organization
HARRIS TEETER LLC
Active
Other names
Harris Teeter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
134 TOWN CENTER DR, SUITE H, MOORESVILLE, NC 28117-9158
(704) 799-1066
(704) 844-6556
Mailing address
1014 VINE ST, CINCINNATI, OH 45202-1141
(513) 762-1019
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10059
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497678
—
NC
01
—
3410711
NABP
—
01
—
7704929
MEDICAID DME
—
Enumeration date
03/13/2008
Last updated
03/07/2023
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