Harris Teeter Pharmacy #63

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

23744 Issued in NC

Legal business name

HARRIS TEETER PHARMACY #63

Practice address

3679 Sunset Ave
Rocky Mount, NC 27804-3411

Phone

(252) 937-2161

Fax

(252) 451-2594

NPI assigned

Aug 5, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Corey Lee Koonce, PHARMD

Title

Pharmacy Manager

Phone

(252) 937-2161

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1962811893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3679 SUNSET AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043411",
            "telephone_number": "252-937-2161",
            "fax_number": "252-451-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3679 SUNSET AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043411",
            "telephone_number": "252-937-2161",
            "fax_number": "252-451-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS TEETER PHARMACY #63",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "KOONCE",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "252-937-2161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "23744",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "202212187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwight Eugene Harper, LCSW
• Rebecca Harper, PHARMD
• Tiffiney Tylaine Harper, D.D.S
• Evans Emmett Harrell, PHD
• Harris Family Group LLC.
• Harris Teeter, LLC
• Allison Moore Harris, PHARM.D
• Terry Harris
• Tommy Ray Harris, MD
• Mercedes Harrison, RESPIRATORY

• Community/Retail Pharmacy in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.