NPIMap

Organization Active NPI

Giant of Maryland LLC

Doing business as Giant Pharmacy 342

  • Community/Retail Pharmacy
  • Marlow HGTS, MD
National Provider Identifier
1154356103
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PO1412 Issued in MD
Legal business name
GIANT OF MARYLAND LLC
Doing business as
Giant Pharmacy 342
Practice address
4119 Branch Ave
Marlow HGTS, MD 20748-1713
Phone
(301) 630-7810
Fax
(301) 702-9543
NPI assigned
Jul 11, 2006
Last updated
Jun 19, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
AHOLD USAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Authorized official

Name
Mr. Raymond McCall, RPH
Title
SVP of Health & Household
Phone
(717) 960-5666

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PO1412 MD
Pharmacy 333600000X PO1412 MD
Community/Retail Pharmacy 3336C0003X PO1412 MD Primary

Addresses

Primary practice location

4119 Branch Ave
Marlow HGTS, MD 20748-1713

Mailing address

1149 Harrisburg Pike
Third Party Coordinator
Carlisle, PA 17013-1607
Phone (717) 960-8553

Other identifiers 2

IdentifierTypeStateIssuer
2115687OtherOTHER ID NUMBER-COMMERCIAL NUMBER
692702500MedicaidMD

Other names 1

  • GIANT PHARMACY 342 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
O20100930003661 MD DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Marlow Heights, 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
21D2173330Giant Pharmacy #3424119 Branch Avenue, Marlow Heights, MD 20748Certificate of waiverOct 9, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant of Maryland LLC4119 Branch Ave, Marlow Heights, MD 20748-1713(301) 630-7810 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
Giant of Maryland LLC162 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

Locations

4119 Branch Ave
Marlow Hgts, MD 20748
Phone (301) 630-7810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497830400000",
    "number": "1154356103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HARRISBURG PIKE",
            "address_2": "THIRD PARTY COORDINATOR",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131607",
            "telephone_number": "717-960-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 BRANCH AVE",
            "city": "MARLOW HGTS",
            "state": "MD",
            "postal_code": "207481713",
            "telephone_number": "301-630-7810",
            "fax_number": "301-702-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHOLD USA",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-06-19",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "SVP OF HEALTH & HOUSEHOLD",
        "authorized_official_telephone_number": "717-960-5666",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "PO1412",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO1412",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PO1412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2115687",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692702500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 342",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.