Giant of Maryland LLC
Organization Active NPI Community/Retail Pharmacy · Accokeek, MD
NPI 1013940360 · NPPES record last updated Jun 19, 2017
Key facts
- NPI
- 1013940360
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P03138 (MD)
- Legal business name
- GIANT OF MARYLAND LLC
- Practice address
- 7025 Berry Rd
Accokeek, MD 20607-3419 - Phone
- (301) 893-3101
- Fax
- (301) 893-3103
- NPI assigned
- Jul 9, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- AHOLD USA
Authorized official
- Name
- Mr. Raymond McCall, RPH
- Title
- SVP of Health & Household
- Phone
- (717) 960-5666
Corporate family (same tax ID) 13
Practitioners 2
-
Nurlean Hale-Holman, RPH
-
Kareemah Muhammad, PHARM D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2170769 | Giant Pharmacy #338 | Certificate of waiver | Aug 19, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Giant of Maryland LLC |
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 assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080916000625 | TX | Part B Supplier - Centralized Flu Biller | 7113914219 | This NPI is an additional NPI on the enrollment |
| O20100930057381 | MD | DME Supplier - Pharmacy |
7113914219 | Practice locations: Accokeek, MD |
National Provider Directory
- Tax ID family
- Ahold USA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | P03138 | MD | |
| Pharmacy | 333600000X | P03138 | MD | |
| Community/Retail Pharmacy | 3336C0003X | P03138 | MD | Yes |
Addresses
Primary practice location
7025 Berry Rd
Accokeek, MD 20607-3419
Mailing address
1149 Harrisburg Pike
Third Party Coordinator
Carlisle, PA 17013-1607
Phone (717) 960-8553
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2126907 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 401957100 | Medicaid | MD |
Other names
- GIANT PHARMACY 338
Other providers in Accokeek, MD
- Extensions of Hope
- Lilian Onyinye Ezeora
- Oluchukwu Augustina Ezeora
- Christopher Ford
- Bernice Gates Hall Chapman
- Ingrid Liddell Goganious
- Janeika Grant
- Chelsea Guillory
- Terrence Gunthrope
- Adrianne Alece Hagood
All providers in Accokeek, MD · Community/Retail Pharmacy in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.