Provider Demographics
NPI:1649563727
Name:HARRIS TEETER PHARMACY
Entity Type:Organization
Organization Name:HARRIS TEETER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SCHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-467-6133
Mailing Address - Street 1:98 CORNERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8404
Mailing Address - Country:US
Mailing Address - Phone:919-467-6133
Mailing Address - Fax:919-467-9978
Practice Address - Street 1:98 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8404
Practice Address - Country:US
Practice Address - Phone:919-467-6133
Practice Address - Fax:919-467-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC076353336C0003X
ND30363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy