HARRIS TEETER LLC NPI 1194922930

NPI Information

  • NPI: 1194922930
  • Provider Name: HARRIS TEETER LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Other Name: HARRIS TEETER PHARMACY
  • CLIA Number: 49D2156435
  • Address: 3600 SOUTH GLEBE RD
    ARLINGTON, VA
    ZIP 22202
  • Phone: (703) 412-9144

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NPI Details

HARRIS TEETER LLC is a community/retail pharmacy pharmacy in Arlington, VA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. HARRIS TEETER LLC NPI is 1194922930. The provider is registered as an organization entity type.
The provider Other Name Is Harris Teeter Pharmacy.

The provider's business location address is:

3600 SOUTH GLEBE RD
ARLINGTON, VA
ZIP 22202
Phone: (703) 412-9144
Fax: (704) 844-6556

The provider's authorized official is Allison Bredestege .
The authorized official title is Pharmacy Licensing Manager and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 49D2156435 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Adm sarscv2 30mcg trs-sucr 1 (HCPCS:0051A)

The enumeration date for this NPI number is 6/27/2007 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy0201004167VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11194922930MEDICAIDVIRGINIA
24840193OTHERNABP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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