HARRIS TEETER, LLC (NPI# 1902991375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902991375 |
| Entity Type | Organization |
| Organization Name | HARRIS TEETER, LLC |
| Other Organization Name | HARRIS TEETER PHARMACY |
| Practice Address |
2281 Cloverdale Ave. Winston Salem NC 27103 |
| Mailing Address |
701 Crestdale Rd. Matthews NC 28105 |
| Practice Telephone | 3367730628 |
| Practice Fax Number | 7048446556 |
| Mailing Telephone | 7048443100 |
| Mailing Fax Number | 7048446556 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-10-09 |
| Authorized Official Name | MR. ROSE WARD (MANAGER, PHARMACY ADMIN/AR) |
| Authorized Official Telephone | 7048446524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 08086 | NC | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
08086 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 0347080 | 05 | |
| NABP | 3439773 | 01 | |
| MEDICAID DME | 7703709 | 01 | |
| DEA | BH7808782 | 01 |
| Other Name | Type Code |
|---|---|
| Harris Teeter Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851742050 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 2032 Waterscape Way, New Bern, NC 28562 | 2016-06-29 |
| 1760805931 | Harris Teeter, LLC | Pharmacy | 3779 Boston Street, Baltimore, MD 21224 | 2014-01-24 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1093142796 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 22700 Sweet Shrub Drive, Clarksburg, MD 20871 | 2013-09-26 |
| 1740535715 | Harris Teeter, LLC | Pharmacy | 3050 Traemoor Village Dr, Fayetteville, NC 28306 | 2012-07-17 |
| 1144596438 | Harris Teeter, LLC | Pharmacy | 105 Purcellville Gateway Dr, Purcellville, VA 20132-3485 | 2012-03-30 |
| 1881968345 | Harris Teeter, LLC | Pharmacy | 3249 Tyre Neck Rd, Portsmouth, VA 23703-3328 | 2012-03-01 |
| 1407129885 | Harris Teeter, LLC | Pharmacy | 33 Office Park Rd, Suite 100, Hilton Head, SC 29928-4612 | 2012-02-16 |
| 1487937512 | Harris Teeter, LLC | Pharmacy | 1801 Whetstone Way, Baltimore, MD 21230 | 2011-09-26 |
| 1386923761 | Harris Teeter, LLC | Pharmacy | 545 Radford Ln, Charlottesville, VA 22903-7465 | 2011-08-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | Harris Teeter, LLC | 701 Crestdale Rd , Matthews, NC 28105-1700 |
| Virginia Business Entity | Harris Teeter, LLC | 701 CRESTDALE RD , MATTHEWS, NC 28105 |
| Street Address |
2281 CLOVERDALE AVE. |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| 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 |
|---|---|---|---|---|
| 1972958361 | Nuestra Farmacia | Pharmacy | 516 Waughtown Street, Winston Salem, NC 27107-6835 | 2016-05-04 |
| 1235400128 | Robinhood Family Pharmacy LLC | Pharmacy | 3443 Robinhood Rd, Ste S, Winston Salem, NC 27106-4760 | 2012-01-24 |
| 1407188451 | Jai Siddhi Vinayak Inc. | Pharmacy | 1489 New Walkertown Rd, Winston Salem, NC 27101-3319 | 2010-02-02 |
| 1659512879 | Stanleyville Family Pharmacy Inc | Pharmacy | 475 Summit Square Blvd, Winston Salem, NC 27105-1485 | 2009-03-18 |
| 1962688598 | Walgreen Co. | Pharmacy | 1327 Meadowlark Dr, Winston Salem, NC 27106-9817 | 2008-01-14 |
| 1518042613 | Andrews Pharmacy, Inc. | Pharmacy | 1305 S Hawthorne Rd, Winston Salem, NC 27103-4121 | 2006-10-26 |
| 1124121975 | North Carolina Cvs Pharmacy LLC | Pharmacy | 3325 Robinhood Rd, Winston Salem, NC 27106-5403 | 2006-09-07 |
| 1669575007 | North Carolina Cvs Pharmacy LLC | Pharmacy | 855 Hanes Mall Blvd, Winston Salem, NC 27103-5526 | 2006-09-07 |
| 1578666269 | North Carolina Cvs Pharmacy LLC | Pharmacy | 5001 Country Club Rd, Winston Salem, NC 27104-4513 | 2006-09-07 |
| 1013924018 | Walgreen Co | Pharmacy | 3634 Reynolda Rd, Winston Salem, NC 27106-2230 | 2006-08-02 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on HARRIS TEETER, LLC.
| 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.