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	3336C0003X	Community/Retail Pharmacy	0201004046	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4838910	OTHER		NCBP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922193051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS TEETER, LLC

Provider Business Mailing Address
First Line	:	701 CRESTDALE RD.
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105
Country	:	US
Telephone Number	:	704-844-3100
Fax Number	:	704-844-6556

Provider Business Practice Location Address
First Line	:	2476 NIMMO PARKWAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456
Country	:	US
Telephone Number	:	757-563-9414
Fax Number	:	704-844-6556

Authorized Official
Title or Position	:	MANAGER, PHARMACY ADMIN/AR
Name	:	ROSE WARD
Credential	:
Telephone Number	:	704-844-6524

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	03/07/2023

Similar Medicare Providers

1760161723 — MRS. TRACY LYNN GAUCK DNP, WHNP
Practice Location Address:

2075 GLENN MITCHELL DR STE 500
VIRGINIA BEACH, VA
23456-0179

Practice Phone: 757-403-5020
Practice Fax:

1467397273 — MATTHEW QUINN VILLANUEVA
Practice Location Address:

2428 HILLCREST MEADOWS LN
VIRGINIA BEACH, VA
23456-8085

Practice Phone: 757-450-8751
Practice Fax:

1003751702 — SACRED CIRCLE THERAPY, LLC
Practice Location Address:

4661 BOXFORD RD
VIRGINIA BEACH, VA
23456-4872

Practice Phone: 757-276-1242
Practice Fax:

1265122477 — HALEY SWOOPE LPC, NCC
Practice Location Address:

2216 MONSARAT LN
VIRGINIA BEACH, VA
23456-5249

Practice Phone: 757-282-1549
Practice Fax:

1063357234 — MS. URJA PATEL PHARMD
Practice Location Address:

3364 PRINCESS ANNE RD
VIRGINIA BEACH, VA
23456-2610

Practice Phone: 757-468-5879
Practice Fax:

1285570176 — NEUROHIVE THERAPEUTIC COLLABORATIVE, LLC
Practice Location Address:

2401 LOCUST GROVE LN
VIRGINIA BEACH, VA
23456-6715

Practice Phone: 775-777-7306
Practice Fax: 775-777-7306

1780031500 — SAVANNAH FABIEN DPT
Practice Location Address:

1772 PERLA DR
VIRGINIA BEACH, VA
23456-1680

Practice Phone: 757-748-4424
Practice Fax:

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 © 2007-2026 (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.