NPIMap

Giant of Maryland LLC

Organization Active NPI Community/Retail Pharmacy · Baltimore, MD

NPI 1063447019 · NPPES record last updated Sep 23, 2011

Key facts

NPI
1063447019
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
GIANT OF MARYLAND LLC
Practice address
7944 Honeygo Blvd
Baltimore, MD 21236-4919
Phone
(410) 931-7533
Fax
(410) 931-7531
NPI assigned
Jul 11, 2006
Organization subpart
No

Authorized official

Name
Brad Dayton
Title
Director
Phone
(617) 770-8782

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2131877Giant Pharmacy #197
7944 Honeygo Boulevard, Baltimore, MD 21236		Certificate of waiverJun 6, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #197
7944 Honeygo Blvd, Baltimore, MD 21236-4919 · (410) 931-7533		 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
Participating since Sep 1, 2010

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080916000625 TX Part B Supplier - Centralized Flu Biller 7113914219 This NPI is an additional NPI on the enrollment
O20100930041299 MD DME Supplier - Pharmacy
DME Supplier - Grocery Store		 7113914219 Practice locations: Baltimore, MD

National Provider Directory

Tax ID family
Ahold USA (162 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 4081710074 MD
Pharmacy 333600000X PO1442 MD
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

7944 Honeygo Blvd
Baltimore, MD 21236-4919

Mailing address

7944 Honeygo Blvd
Baltimore, MD 21236-4919

Other identifiers

IdentifierTypeStateIssuer
696404400MedicaidMD
2116071OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names

  • GIANT PHARMACY 197 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 23, 2011.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1063447019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7944 HONEYGO BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7944 HONEYGO BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364919",
            "telephone_number": "410-931-7533",
            "fax_number": "410-931-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "DAYTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-770-8782"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "4081710074",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO1442",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696404400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2116071",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 197",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

All providers in Baltimore, MD · Community/Retail Pharmacy in Maryland

Sources for this page

Verify at the official NPI Registry.