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General NPI Number Information
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NPI Number | 1083877591
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Entity Type | Organization
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Legal Business Name | HARRIS TEETER LLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1125 WEST NC 54 HWY
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City | DURHAM
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State | NC
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Zip | 27707
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Country | US
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Telephone | 919-403-8053
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Fax | 704-844-6556
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Provider Business Mailing Address
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Address Line | 701 CRESTDALE RD
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City | MATTHEWS
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State | NC
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Zip | 28105-1700
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Country | US
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Telephone | 704-844-3100
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Fax | 704-844-6556
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Authorized Official
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Title or Position | MANAGER PHARMACY LICENSING
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Name | LYSETTE SEILHAMER
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Credential |
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Telephone | 513-587-5328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 10118
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 10118
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License Number State | NC
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