NPIMap

Organization Active NPI

Harris Teeter, LLC

  • Community/Retail Pharmacy
  • Washington, DC
National Provider Identifier
1114235512
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HARRIS TEETER, LLC
Practice address
1201 First Street NE
Washington, DC 20002-4274
Phone
(202) 589-0127
Fax
(202) 589-0758
NPI assigned
Sep 20, 2010
Last updated
Oct 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rose Ward
Title
Dir., Pharmacy Accounting
Phone
(704) 844-6524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1201 First Street NE
Washington, DC 20002-4274

Mailing address

701 Crestdale Rd
Matthews, NC 28105-1700
Phone (704) 844-3100

Other names 1

  • HARRIS TEETER PHARMACY Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101104000770 DC Part B Supplier - Pharmacy 9234255217 18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Germantown, MD; Washington, DC; Potomac, MD; Olney, MD; Bowie, MD; Bethesda, MD
O20110913000328 DC DME Supplier - PharmacyDME Supplier - Grocery Store 9234255217 Practice locations: Washington, DC

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
09D2100346Harris Teeter #3521201 First Street NE, Washington, DC 20002Certificate of waiverAug 11, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Harris Teeter #3521201 First Street NE, Washington, DC 20002-4274(202) 589-0127 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… Accepts assignmentParticipating since Mar 22, 2011

National Provider Directory

National Provider Directory
Tax ID family
Harris Teeter LLC208 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1201 1st St NE
Washington, DC 20002
Phone (202) 589-0127

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1114235512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CRESTDALE RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051700",
            "telephone_number": "704-844-3100",
            "fax_number": "704-844-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FIRST STREET NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024274",
            "telephone_number": "202-589-0127",
            "fax_number": "202-589-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "DIR., PHARMACY ACCOUNTING",
        "authorized_official_telephone_number": "704-844-6524"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HARRIS TEETER PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.