NPIMap

Organization Active NPI

Harris Teeter, LLC

Doing business as Harris Teeter Pharmacy #332

  • Community/Retail Pharmacy
  • Charlottesville, VA
National Provider Identifier
1386923761
Registry record updated Oct 9, 2014
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 #332
Practice address
545 Radford LN
Charlottesville, VA 22903-7465
Phone
(434) 823-4151
Fax
(434) 823-4196
NPI assigned
Aug 16, 2011
Last updated
Oct 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Rose W Ward
Title
Director, Pharmacy Administration
Phone
(704) 844-6524

Specialties & licenses 1

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

Addresses

Primary practice location

545 Radford LN
Charlottesville, VA 22903-7465

Mailing address

701 Crestdale Rd
Matthews, NC 28105-1700
Phone (704) 844-6524

Other names 1

  • Harris Teeter Pharmacy #332 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111221000020 VA DME Supplier - Pharmacy 9234255217 Practice locations: Charlottesville, VA
O20140217000368 VA Part B Supplier - Mass Immunization (Roster Biller Only) 9234255217 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamsburg, VA; Virginia Beach, VA; Norfolk, VA; Gainsville, VA; Charlottesville, VA

Other NPIs on the same Medicare enrollment 7

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

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
49D2103245Harris Teeter Pharmacy #332545 Radford Lane - Building a, Charlottesville, VA 22903Certificate of waiverOct 7, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Harris Teeter, LLC545 Radford LN, Charlottesville, VA 22903-7465(434) 823-4151 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 20

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

View all 20

Member of 1

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

Locations

545 Radford Ln
Charlottesville, VA 22903
Phone (434) 823-4151

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1386923761",
    "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": "704-844-6524",
            "fax_number": "704-844-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 RADFORD LN",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229037465",
            "telephone_number": "434-823-4151",
            "fax_number": "434-823-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACY ADMINISTRATION",
        "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 #332",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.