NPIMap

Organization Active NPI

Harris Teeter, LLC

Doing business as Harris Teeter Pharmacy

  • Community/Retail Pharmacy
  • Purcellville, VA
National Provider Identifier
1144596438
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HARRIS TEETER, LLC
Doing business as
Harris Teeter Pharmacy
Practice address
105 Purcellville Gateway Dr
Purcellville, VA 20132-3485
Phone
(540) 338-3155
Fax
(540) 338-2643
NPI assigned
Mar 30, 2012
Last updated
Aug 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Authorized official

Name
Allison Muennich
Title
Manager of Pharmacy Licensing
Phone
(513) 762-1019

Specialties & licenses 1

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

Addresses

Primary practice location

105 Purcellville Gateway Dr
Purcellville, VA 20132-3485

Mailing address

PO Box 842772
Boston, MA 02284
Phone (513) 762-1019

Other identifiers 1

IdentifierTypeStateIssuer
4843795OtherNCPDP

Other names 1

  • Harris Teeter Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101229000190 VA Part B Supplier - Pharmacy 9234255217 40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portsmouth, VA; Purcellville, VA; Sterling, VA; Chesapeake, VA; Suffolk, VA; Virginia Beach, VA; Warrenton, VA; Williamsburg, VA…
O20120808000491 VA DME Supplier - Pharmacy 9234255217 Practice locations: Purcellville, VA

Other NPIs on the same Medicare enrollment 39

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

View all 39

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
49D2102874Harris Teeter #388105 Purcellville Gateway Drive, Purcellville, VA 20132Certificate of waiverSep 29, 2027

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 14

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

View all 14

Member of 1

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

Locations

105 Purcellville Gateway Dr
Purcellville, VA 20132
Phone (540) 338-3155

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1144596438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02284",
            "telephone_number": "513-762-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PURCELLVILLE GATEWAY DR",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201323485",
            "telephone_number": "540-338-3155",
            "fax_number": "540-338-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4843795",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harris Teeter Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Purcellville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.