Active NPI
Harris Teeter, LLC
- Community/Retail Pharmacy
- Bethesda, MD
National Provider Identifier
1578719142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- P04799
- Legal business name
- HARRIS TEETER, LLC
- Practice address
- 11845 Old Georgetown Rd.
Bethesda, MD 20852 - Phone
- (301) 468-3238
- Fax
- (704) 844-6556
- NPI assigned
- Aug 14, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Rose Ward
- Title
- Manager-Pharmacy Admin/Ar
- Phone
- (704) 844-6524
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | P04799 | MD | Primary |
Addresses
Primary practice location
11845 Old Georgetown Rd.
Bethesda, MD 20852
Mailing address
701 Crestdale Rd
Matthews, NC 28105-1700
Phone (704) 844-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018916200 | Medicaid | MD | |
| 2134118 | Other | NCPDP |
Other names 1
- HarrisTeeter Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
Other NPIs on the same Medicare enrollment 17
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2155477 | Harris Teeter Pharmacy #97-0328 | Certificate of waiver | Sep 30, 2026 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1578719142",
"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": "11845 OLD GEORGETOWN RD.",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20852",
"telephone_number": "301-468-3238",
"fax_number": "704-844-6556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HARRIS TEETER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-14",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "WARD",
"authorized_official_first_name": "ROSE",
"authorized_official_title_or_position": "MANAGER-PHARMACY ADMIN/AR",
"authorized_official_telephone_number": "704-844-6524",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MD",
"license": "P04799",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "018916200",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2134118",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HarrisTeeter Pharmacy",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bethesda, MD
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.
- 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.