Organization
HARRIS TEETER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
20070 ASHBROOK COMMONS PLZ, ASHBURN, VA 20147-5034
(571) 233-0517
(571) 223-0542
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0201004030
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010192587
—
VA
01
—
4838744
NCBP
—
Enumeration date
10/02/2006
Last updated
03/07/2023
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