NPIMap

Organization Active NPI

Harris Teeter 046

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1497048763
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14566 Issued in NC
Legal business name
HARRIS TEETER 046
Practice address
9641 Brookdale Dr
Charlotte, NC 28215-8706
Phone
(704) 599-8670
Fax
(704) 599-8498
NPI assigned
May 19, 2011
Last updated
May 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
Mr. Carmen MontanteNPI 1013293901
Title
Pharmacy Manager
Phone
(704) 599-8670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 14566 NC Primary

Addresses

Primary practice location

9641 Brookdale Dr
Charlotte, NC 28215-8706

Mailing address

9641 Brookdale Dr
Charlotte, NC 28215-8706
Phone (704) 599-8670

Other identifiers 1

IdentifierTypeStateIssuer
0609767MedicaidNC

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 24

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

View all 24

Locations

9641 Brookdale Dr
Charlotte, NC 28215
Phone (704) 599-8670

Practitioners & affiliated clinicians

Practitioners 1

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": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1497048763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9641 BROOKDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158706",
            "telephone_number": "704-599-8670",
            "fax_number": "704-599-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9641 BROOKDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158706",
            "telephone_number": "704-599-8670",
            "fax_number": "704-599-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER 046",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "MONTANTE",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "704-599-8670",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "14566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0609767",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.