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HARRIS TEETER, INC.

Community/Retail Pharmacy >> Pharmacy >> Suppliers

Registrant NPI Number: 1255434809

Organizational Registrant:
Organization Name:  HARRIS TEETER, INC.
Organization is not Subpart
Authorized Official:  ROSE  WARD  MANAGER PHARMACY ACCOUNTING  704--84-46524

Location and contact information for practice:
10320 MAIN ST  FAIRFAX, VA 22030-2410 US
Tel: 703-352-8148  Fax: 704-844-6556

Contact information for business:
701 CRESTDALE RD  MATTHEWS, NC 28105-1700 US
Tel: 704-844-3100  Fax: 704-844-6556

Registration Information:
NPI: 1255434809
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0003XSuppliers
Pharmacy
Community/Retail Pharmacy
VA0201003773

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
0929934NC05
MEDICAID DME770310701
NABP34-3501601
DEABH564041701




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