Organization · NPI-2

Harris Teeter LLC

Pharmacy, Community/Retail Pharmacy · Laurel, MD

NPI number1801205505
StatusActive
Last updated in NPPESAug 6, 2014

Details

NPI
1801205505
Entity type
Organization (NPI-2)
Legal business name
Harris Teeter LLC
Organization subpart
No
Enumeration date
Aug 6, 2014
Last updated
Aug 6, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy––Yes

Other names

  • Harris Teeter Pharmacy #408 (Doing Business As)

Practice location

14702 Baltimore Ave
Laurel, MD 20707-4816

Phone 704-844-3418

Mailing address

701 Crestdale Rd
Matthews, NC 28105-1700

Phone 704-844-3418

Authorized official

Mary K Noblitt
License Administrator
7048443418

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