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HARRIS TEETER #34
NPI 1619497583
Pharmacy - Community/Retail Pharmacy in Fernandina Beach, FL

Active since June 22, 2017CLIA 10D2155848 · Waiver
4800 FIRST COAST HWY, FERNANDINA BEACH, FL 32034(704) 844-4147 Get Directions Write a Review

NPPES record last updated: January 9, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 9, 2018, Jun 22, 2017 (2 updates tracked since 2017).

About Harris Teeter #34 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HARRIS TEETER #34 (NPI 1619497583) is a healthcare organization registered as a community/retail pharmacy in Fernandina Beach, Florida and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Allison Bredestege, Pharmacy Licensing Manager, as its authorized official.

NPPES Registry Identity

NPI1619497583
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameHARRIS TEETER LLC
Location Address4800 FIRST COAST HWYFernandina Beach, FL 32034-5597
Mailing AddressPo Box 842772Boston, MA 02284-2772
Phone(704) 844-4147
Organization SubpartNo
Authorized OfficialAllison BredestegePharmacy Licensing Manager · (513) 762-1019
Enumeration DateJune 22, 2017
Last NPPES UpdateJanuary 9, 20182 updates tracked since enumeration
✔ NPI 1619497583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
4800 FIRST COAST HWY, Fernandina Beach, FL 32034
Open in Google Maps ↗

Other Names 1

Doing Business AsHarris Teeter #34

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2155848

Harris Teeter Dba Harris Teeter Pharmacy #97-0034 · Fernandina Beach, FL
Active · expires Oct 4, 2026
CLIA Number10D2155848
Laboratory TypePharmacy
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorLindsay Schifando
Laboratory Phone(904) 491-9803
Laboratory LocationHarris Teeter Dba Harris Teeter Pharmacy #97-00344800 First Coast Hwy, Fernandina Beach, FL 32034
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
494 services489 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
486 services481 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
42 services42 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
42 services42 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Harris Teeter LLC carries, from the Medicare DMEPOS supplier directory.

Harris Teeter LLC

DMEPOS supplier · Fernandina Beach, FL
✔

Accepts Medicare assignment

Harris Teeter LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20530667
Medicare Participant SinceMarch 22, 2011
Supplier Location4800 First Coast HwyFernandina Beach, FL 32034
Phone(904) 491-9803
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HEATHER NEIGHBORS
Pharmacist
4800 FIRST COAST HWY
FERNANDINA BEACH, FL 32034
Nassau County (904) 491-9803
MISS HEATHER RAE TUERSCHMANN PT, DPT
Physical Therapist
4800 FIRST COAST HWY, STE. 240
FERNANDINA BEACH, FL 32034
Nassau County (904) 321-5491

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Harris Teeter LLC's NPI number?

The NPI number for Harris Teeter LLC is 1619497583. It was assigned to this organization in the NPPES registry on June 22, 2017. The provider is doing business as Harris Teeter #34.

Where is Harris Teeter LLC located?

Harris Teeter LLC is located at 4800 First Coast Hwy, Fernandina Beach, FL 32034. The listed phone number is (704) 844-4147.

What is Harris Teeter LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Harris Teeter LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Harris Teeter LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Harris Teeter LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2155848) is associated with this NPI, valid through October 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Harris Teeter LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 47 other insurers list Harris Teeter LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Harris Teeter LLC was last updated on January 9, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.