MEDICARE: HARRIS TEETER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1881021582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS TEETER LLC

Provider Business Mailing Address
First Line	:	PO BOX 842772
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02284-2772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1981 RIVIERA DRIVE
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7401
Country	:	US
Telephone Number	:	704-844-3418
Fax Number	:	704-844-6512

Authorized Official
Title or Position	:	PHARMACY LICENSING MANAGER
Name	:	ALLISON BREDESTEGE
Credential	:
Telephone Number	:	513-762-1019

Provider Enumeration Date	:	09/26/2013
Last Update Date	:	02/09/2017

Similar Medicare Providers

1932836558 — DR. MIRANDA HURLEY PHARMD
Practice Location Address:

1981 RIVIERA DR
MOUNT PLEASANT, SC
29464-7401

Practice Phone: 843-849-1515
Practice Fax:

1316935547 — MRS. JOHNNIE LOIS WEASE NP
Practice Location Address:

1189 IRON BRIDGE DR , #100
MOUNT PLEASANT, SC
29466-7401

Practice Phone: 843-856-1210
Practice Fax:

1104983287 — PIGGLY WIGGLY MT PLEASANT INC
Practice Location Address:

1981 RIVIERA DR
MT PLEASANT, SC
29464-7401

Practice Phone: 843-849-1515
Practice Fax: 843-849-2017

1851952287 — DUSTIN GREGORY REXROAD PHARMD
Practice Location Address:

1981 RIVIERA DR
MT PLEASANT, SC
29464-7401

Practice Phone: 843-849-1515
Practice Fax:

1801883061 — RICHARD D ALLATT MD
Practice Location Address:

550 W COLLEGE AVE
PLEASANT GAP, PA
16823-7401

Practice Phone: 814-359-5620
Practice Fax: 814-359-5629

1902879620 — ENCOMPASS HEALTH REHABILITATION HOSPITAL OF NITTANY VALLEY, INC.
Practice Location Address:

550 W COLLEGE AVE
PLEASANT GAP, PA
16823-7401

Practice Phone: 814-359-3421
Practice Fax: 814-359-5898

Directions to “HARRIS TEETER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.