NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Cockeysville, MD
National Provider Identifier
1124051479
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PO1513 Issued in MD
Legal business name
GIANT OF MARYLAND LLC
Practice address
11399 York Rd
Cockeysville, MD 21030-1909
Phone
(410) 785-1065
Fax
(410) 785-1071
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Bob Stone
Title
Dir 3Rd Party and Managed Care
Phone
(617) 770-6257

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PO1513 MD
Community/Retail Pharmacy 3336C0003X PO1513 MD Primary

Addresses

Primary practice location

11399 York Rd
Cockeysville, MD 21030-1909

Mailing address

11399 York Rd
Cockeysville, MD 21030-1909

Other identifiers 2

IdentifierTypeStateIssuer
2116728OtherOTHER ID NUMBER-COMMERCIAL NUMBER
696002200MedicaidMD

Other names 1

  • GIANT PHARMACY 100 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD2 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
O20100930054003 MD DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Cockeysville, MD

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
21D2131878Giant Pharmacy #10011399 York Road, Cockeysville, MD 21030Certificate of waiverJun 6, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #10011399 York Rd, Cockeysville, MD 21030-1909(410) 785-1065 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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1124051479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11399 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11399 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301909",
            "telephone_number": "410-785-1065",
            "fax_number": "410-785-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "DIR 3RD PARTY AND MANAGED CARE",
        "authorized_official_telephone_number": "617-770-6257"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO1513",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PO1513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2116728",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696002200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 100",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cockeysville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.