Organization
HARRIS TEETER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (PHARMACY LICENSING MANAGER)
(513) 762-1019
Entity
Organization
Contact information
Practice address
6271 CAROLINA COMMONS DR., INDIAN LAND, SC 29707
(803) 802-5400
(704) 844-6556
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 844-3100
(704) 844-6556
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5010331
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4229424
NCPDP
—
05
—
710331
—
SC
Enumeration date
01/28/2009
Last updated
03/07/2023
Update your record
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