Organization
HARRIS TEETER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
5000 US HIGHWAY 70 W STE 100, MOREHEAD CITY, NC 28557-4531
(919) 909-6375
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801307269
—
NC
Enumeration date
10/12/2017
Last updated
03/13/2019
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