Giant Eagle Inc
Organization Active NPI Community/Retail Pharmacy · Roaring Spring, PA
NPI 1083629901 · NPPES record last updated Aug 11, 2025
Key facts
- NPI
- 1083629901
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PP414064L (PA)
- Legal business name
- GIANT EAGLE INC
- Practice address
- 510 Marwalt LN
Roaring Spring, PA 16673-2130 - Phone
- (814) 224-4201
- Fax
- (814) 224-0067
- NPI assigned
- Jul 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Kelly Anne Zmarzly
- Title
- Managed Care Credentialing
- Phone
- (412) 968-1529
Corporate family (same tax ID) 17
Member of 2
Practitioners 4
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Giant Eagle Inc |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Ostomy Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061213000490 | PA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8921083049 | This NPI is an additional NPI on the enrollment |
| O20100930096649 | PA | DME Supplier - Pharmacy | 8921083049 | Practice locations: Roaring Spring, PA |
National Provider Directory
- Tax ID family
- Giant Eagle Pharm 2486
Locations
510 Marwalt Ln
Roaring Spring, PA 16673
Phone (814) 224-4201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PP414064L | PA | Yes |
Addresses
Primary practice location
510 Marwalt LN
Roaring Spring, PA 16673-2130
Mailing address
700 Cranberry Woods Dr
Cranberry TWP, PA 16066-5213
Phone (412) 968-1529
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3956111 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 1007285680259 | Medicaid | PA | |
| 870021414 | Other | PA | RRB |
Other names
- GIANT EAGLE PHARMACY 0079
Other providers in Roaring Spring, PA
- Nichole Richelle Emigh
- Patricia A. England
- Julie Ann Evans
- Kerrstin Dawn Focht
- Amanda Rae Foreman
- Jesse Glass
- Kelli Marie Gormont
- Joshua Greenberg
- Grove City Anesthesia & Pain Management, PLLC
- Kasy Hamm
All providers in Roaring Spring, PA · Community/Retail Pharmacy in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2025. 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.