NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Haymarket, VA
National Provider Identifier
1013026640
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201004106 Issued in VA
Legal business name
GIANT OF MARYLAND LLC
Practice address
5581 Merchants View Square
Haymarket, VA 20169
Phone
(571) 248-4551
Fax
(571) 248-4555
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert Stone
Title
Director Third Party
Phone
(617) 770-6257

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0201004106 VA
Community/Retail Pharmacy 3336C0003X 0201004106 VA Primary

Addresses

Primary practice location

5581 Merchants View Square
Haymarket, VA 20169

Mailing address

185 Campanelli Dr
Braintree, MA 02184
Phone (781) 380-5611

Other identifiers 2

IdentifierTypeStateIssuer
4839467OtherVANCPDP
010328471MedicaidVA

Other names 1

  • Giant Pharmacy #790 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080916000625 TX Part B Supplier - Centralized Flu Biller 7113914219 This NPI is an additional NPI on the enrollment
O20100930047919 VA DME Supplier - Pharmacy 7113914219 Practice locations: Haymarket, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2187279Giant Pharmacy #7905581 Merchants View Square, Haymarket, VA 20169Certificate of waiverJun 28, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #7905581 Merchants View Square, Haymarket, VA 20169(571) 248-4551 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Sep 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
Ahold USA162 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

5581 Merchants View Sq
Haymarket, VA 20169
Phone (571) 248-4550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1013026640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 CAMPANELLI DR",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "02184",
            "telephone_number": "781-380-5611",
            "fax_number": "781-380-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5581 MERCHANTS VIEW SQUARE",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "20169",
            "telephone_number": "571-248-4551",
            "fax_number": "571-248-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR THIRD PARTY",
        "authorized_official_telephone_number": "617-770-6257"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201004106",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4839467",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010328471",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giant Pharmacy #790",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haymarket, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.