Active NPI
Harris Teeter LLC
- Community/Retail Pharmacy
- Arlington, VA
National Provider Identifier
1639725112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- HARRIS TEETER LLC
- Practice address
- 950 S George Mason Dr
Arlington, VA 22204-1557 - Phone
- (999) 999-9999
- NPI assigned
- Aug 12, 2019
- 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
- Jessie Warman
- Title
- Manager of Licensing
- Phone
- (513) 762-1090
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
950 S George Mason Dr
Arlington, VA 22204-1557
Mailing address
PO Box 842772
Boston, MA 02284-2772
Other names 1
- HARRIS TEETER PHARMACY #09700371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 20
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
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": "1565568000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565568000000",
"number": "1639725112",
"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": "022842772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 S GEORGE MASON DR",
"city": "ARLINGTON",
"state": "VA",
"postal_code": "222041557",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HARRIS TEETER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-12",
"last_updated": "2019-08-12",
"status": "A",
"authorized_official_last_name": "WARMAN",
"authorized_official_first_name": "JESSIE",
"authorized_official_title_or_position": "MANAGER OF LICENSING",
"authorized_official_telephone_number": "513-762-1090"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "HARRIS TEETER PHARMACY #09700371",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Arlington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.