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
1432 BRODGEN WOODS DR, WAKE FOREST, NC 27587
(919) 870-4984
(919) 870-4990
Mailing address
701 CRESTDALE RD, MATTHEWS, NC 28105-1700
(704) 844-3418
(704) 844-6512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2019
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