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HARRIS TEETER PHARMACY #204
NPI 1629405592
Pharmacy - Community/Retail Pharmacy in Charlotte, NC

Active since October 08, 2013CLIA 34D2100532 · Waiver
8538 PARK RD, CHARLOTTE, NC 28210(704) 553-8378(704) 552-8359 Get Directions Write a Review

NPPES record last updated: February 9, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Harris Teeter Pharmacy #204 NPPES

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

HARRIS TEETER PHARMACY #204 (NPI 1629405592) is a healthcare organization registered as a community/retail pharmacy in Charlotte, North Carolina and active in the NPI registry since October 2013. The organization holds a CLIA Waiver certificate valid through August 16, 2027 and lists Allison Bredestege, Pharmacy Licensing Manager, as its authorized official.

NPPES Registry Identity

NPI1629405592
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameHARRIS TEETER LLC
Location Address8538 PARK RDCharlotte, NC 28210-5803
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019
Phone(704) 553-8378
Fax(704) 552-8359
Organization SubpartNo
Authorized OfficialAllison BredestegePharmacy Licensing Manager · (513) 762-1019
Enumeration DateOctober 8, 2013
Last NPPES UpdateFebruary 9, 2017
✔ NPI 1629405592 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
8538 PARK RD, Charlotte, NC 28210
Open in Google Maps ↗

Other Names 1

Doing Business AsHarris Teeter Pharmacy #204

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 34D2100532

Harris Teeter # 204 · Charlotte, NC
Active · expires Aug 16, 2027
CLIA Number34D2100532
Laboratory TypeTetail Pharmacy
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorLindsay Capozziello
Laboratory Phone(704) 553-8378
Laboratory LocationHarris Teeter # 2048538 Park Road Attn Pharmacist In Charge, Charlotte, NC 28210
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.
236 services236 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.
228 services228 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.
28 services28 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.
28 services28 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 15

Medicare supplier enrollment and the product categories Harris Teeter #204 carries, from the Medicare DMEPOS supplier directory.

Harris Teeter #204

DMEPOS supplier · Charlotte, NCOperated by Harris Teeter LLC
✔

Accepts Medicare assignment

Harris Teeter #204 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)20531165
Medicare Participant SinceMarch 22, 2011
Supplier Location8538 Park RdCharlotte, NC 28210
Phone(704) 553-8378
Supplier Specialties
Pharmacy Grocery Store

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.

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 1629405592. It was assigned to this organization in the NPPES registry on October 8, 2013. The provider is doing business as Harris Teeter Pharmacy #204.

Where is Harris Teeter LLC located?

Harris Teeter LLC is located at 8538 Park Rd, Charlotte, NC 28210. The listed phone number is (704) 553-8378.

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 #204 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 34D2100532) is associated with this NPI, valid through August 16, 2027. 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 46 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 February 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.