NPIMap

Organization Active NPI

Harris Teeter, LLC

  • Community/Retail Pharmacy
  • McLean, VA
National Provider Identifier
1568617173
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201004264 Issued in VA
Legal business name
HARRIS TEETER, LLC
Practice address
8200 Crestwood Heights Drive
McLean, VA 22102
Phone
(703) 448-0679
Fax
(703) 448-0728
NPI assigned
Nov 24, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Rose Ward
Title
Manager, 3Rd Pharmacy Admin/Ar
Phone
(704) 844-6524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0201004264 VA Primary

Addresses

Primary practice location

8200 Crestwood Heights Drive
McLean, VA 22102

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
4841234OtherNCPDP
1568617173MedicaidVA

Other names 1

  • Harris Teeter Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA3 enrollments

Enrollment records 3

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
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…
O20140529001652 DC Part B Supplier - Mass Immunization (Roster Biller Only) 9234255217 20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Arlington, VA; Falls Church, VA; Gaithersburg, MD; Herndon, VA; Laurel, MD; MC Lean, VA; Reston, VA…

Other NPIs on the same Medicare enrollment 57

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

View all 57

National Provider Directory

National Provider Directory

Member of 1

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

Locations

8200 Crestwood Heights Dr
McLean, VA 22102
Phone (703) 448-0679

Practitioners & affiliated clinicians

Practitioners 4

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": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1568617173",
    "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": "8200 CRESTWOOD HEIGHTS DRIVE",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22102",
            "telephone_number": "703-448-0679",
            "fax_number": "703-448-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "MANAGER, 3RD PHARMACY ADMIN/AR",
        "authorized_official_telephone_number": "704-844-6524"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4841234",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568617173",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harris Teeter Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.