HARRIS TEETER, INC. (NPI# 1255434809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255434809 |
| Entity Type | Organization |
| Organization Name | HARRIS TEETER, INC. |
| Other Organization Name | HARRIS TEETER PHARMACY |
| Practice Address |
10320 Main St Fairfax VA 22030-2410 |
| Mailing Address |
701 Crestdale Rd Matthews NC 28105-1700 |
| Practice Telephone | 7033528148 |
| Practice Fax Number | 7048446556 |
| Mailing Telephone | 7048443100 |
| Mailing Fax Number | 7048446556 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2009-02-13 |
| Authorized Official Name | ROSE WARD (MANAGER PHARMACY ACCOUNTING) |
| Authorized Official Telephone | 7048446524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
0201003773 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 0929934 | 05 | |
| MEDICAID DME | 7703107 | 01 | |
| NABP | 34-35016 | 01 | |
| DEA | BH5640417 | 01 |
| Other Name | Type Code |
|---|---|
| Harris Teeter Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447687140 | Harris Teeter, Inc. | Durable Medical Equipment & Medical Supplies | 1985 Folly Rd Unit A, Charleston, SC 29412-9571 | 2013-09-26 |
| 1710158423 | Harris Teeter, Inc. | Pharmacy | 26370 Bay Farm Rd., Millsboro, DE 19966 | 2008-03-20 |
| 1962506543 | Harris Teeter, Inc. | Pharmacy | 3357 Battleground Ave., Greensboro, NC 27410 | 2006-09-12 |
| 1336241405 | Harris Teeter, Inc. | Pharmacy | 840 A1a North, Ponte Vedra Beach, FL 32082 | 2006-09-01 |
| 1942563416 | Harris Teeter, Inc. | Pharmacy | 7036 Brighton Park Dr, Mint Hill, NC 28227-7971 | 2012-06-20 |
| Street Address |
10320 MAIN ST |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790307627 | Bei Wang | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2020-05-14 |
| 1740665306 | Baohan Le | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2015-07-24 |
| 1467844597 | Michelle Creasy | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2015-02-26 |
| 1710258652 | Dewayne Johnson | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2012-01-24 |
| 1336418029 | Maria Jacqueline Thompson | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2011-12-26 |
| 1588949010 | Laura Nackman | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2011-10-16 |
| 1134409725 | Thoa D Le | Pharmacist | 10320 Main St, Fairfax, VA 22030-2410 | 2011-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417411414 | District Rx LLC | Pharmacy | 8301 Arlington Blvd Ste 107, Fairfax, VA 22031-2902 | 2019-01-24 |
| 1194240077 | Qurex Pharmacy | Pharmacy | 3949 Pender Dr Ste 130, Fairfax, VA 22030-6033 | 2017-08-11 |
| 1942689609 | Medex Health Group LLC | Pharmacy | 3023 Hamaker Ct Ste Ll110, Fairfax, VA 22031-2630 | 2015-05-27 |
| 1598093627 | Harris Teeter, LLC | Pharmacy | 3905 Fair Ridge Dr, Fairfax, VA 22033-2906 | 2009-12-01 |
| 1649378100 | Virginia Cvs Pharmacy LLC | Pharmacy | 10090 Fairfax Blvd, Fairfax, VA 22030-1741 | 2006-09-20 |
| 1598869257 | Virginia Cvs Pharmacy LLC | Pharmacy | 10390 Willard Way, Fairfax, VA 22030-2508 | 2006-09-12 |
| 1619071370 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 13031 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2048 | 2006-09-12 |
| 1609986231 | Costco Wholesale Corporation | Pharmacy | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2006-08-30 |
| 1275572620 | Bjs Wholesale Club Inc | Pharmacy | 13053 Fair Lakes Shopping Ctr, Fairfax, VA 22033-5179 | 2006-06-04 |
| 1942250816 | Fairfax Pharmacy Inc. | Pharmacy | 1275 Allendale Fairfax Hwy, Fairfax, SC 29827-9124 | 2006-05-11 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.