NPI: 1639588320 · WASHINGTON, DC 20003 · Community/Retail Pharmacy · NPI assigned 08/06/2014
| Authorized Official | NOBLITT, MARY (LICENSE ADMINISTRATOR) |
| NPI Enumeration Date | 08/06/2014 |
Other providers sharing the same authorized official: NOBLITT, MARY
| Provider | City | State | Total Paid |
|---|---|---|---|
| HARRIS TEETER LLC | GOLDSBORO | NC | $430.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0012A | 12 | 12 | $0.00 |