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General NPI Number Information
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NPI Number | 1215488440
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Entity Type | Organization
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Legal Business Name | HARRIS TEETER
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 4010 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-9296
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Country | US
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Telephone | 336-288-2246
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-9296
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY OPERATIONS MANAGER
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Name | BILLY SOFFERA
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Credential |
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Telephone | 704-238-3759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26222
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License Number State | NC
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