Organization
HARRIS TEETER PHARMACY #63
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY LEE KOONCE PHARMD (PHARMACY MANAGER)
(252) 937-2161
Entity
Organization
Contact information
Practice address
3679 SUNSET AVE, ROCKY MOUNT, NC 27804-3411
(252) 937-2161
(252) 451-2594
Mailing address
3679 SUNSET AVE, ROCKY MOUNT, NC 27804-3411
(252) 937-2161
(252) 451-2594
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
202212187
VA
3336C0003X
Community/Retail Pharmacy
Primary
23744
NC
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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