Giant of Maryland LLC
Organization Active NPI Community/Retail Pharmacy · Oxon Hill, MD
NPI 1023041373 · NPPES record last updated Jun 19, 2017
Key facts
- NPI
- 1023041373
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PO2072 (MD)
- Legal business name
- GIANT OF MARYLAND LLC
- Practice address
- 20 Audrey LN
Oxon Hill, MD 20745-1301 - Phone
- (301) 839-8181
- Fax
- (301) 749-5190
- NPI assigned
- Jul 9, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- AHOLD USA
Authorized official
- Name
- Raymond McCall, RPH
- Title
- SVP of Health & Household
- Phone
- (717) 960-5666
Corporate family (same tax ID) 15
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2173126 | Giant Pharmacy #341 | Certificate of waiver | Oct 6, 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 |
| O20100930028679 | MD | DME Supplier - Pharmacy |
7113914219 | Practice locations: Oxon Hill, MD |
National Provider Directory
- Tax ID family
- Ahold USA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | PO2072 | MD | |
| Pharmacy | 333600000X | PO2072 | MD | |
| Community/Retail Pharmacy | 3336C0003X | PO2072 | MD | Yes |
Addresses
Primary practice location
20 Audrey LN
Oxon Hill, MD 20745-1301
Mailing address
1149 Harrisburg Pike
Third Party Coordinator
Carlisle, PA 17013-1607
Phone (717) 960-8553
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2121969 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 696503200 | Medicaid | MD |
Other names
- GIANT PHARMACY 341
Other providers in Oxon Hill, MD
- Gastrointestinal Associates of Maryland PA
- Gastrointestinal Specialists LLC
- Nebiat K Gebremariam
- Jocelyn Elizabeth George
- Dunia Ghazala
- Gilead Lifeworks Behavioral Health Services
- Maria Yolanda Giraldo-Jimenez
- Danika Girdner
- Jerry L Glenn II
- Enrique Gonzalez-Bernard
All providers in Oxon Hill, 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.