NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Annandale, VA
National Provider Identifier
1255365136
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201003052 Issued in VA
Legal business name
GIANT OF MARYLAND LLC
Practice address
6980 Braddock Road
Annandale, VA 22003
Phone
(703) 333-6361
Fax
(703) 333-6390
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0201003052 VA
Pharmacy 333600000X 0201003052 VA
Community/Retail Pharmacy 3336C0003X 0201003052 VA Primary

Addresses

Primary practice location

6980 Braddock Road
Annandale, VA 22003

Mailing address

6980 Braddock Road
Annandale, VA 22003

Other identifiers 2

IdentifierTypeStateIssuer
010023718MedicaidVA
4837704OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • GIANT PHARMACY 249 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA2 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
O20100930018745 VA DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Annandale, VA

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
49D2186583Giant Pharmacy #2496980 Braddock Road, Annandale, VA 22003Certificate of waiverJun 17, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant of Maryland LLC6980 Braddock Rd, Annandale, VA 22003-6036(703) 333-6361 Epoetin|Immunosuppressive Drugs|Infusion 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 23

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

View all 23

Locations

6980 Braddock Rd
Annandale, VA 22003

6980 Braddock Rd
Annandale, VA 22003
Phone (703) 333-6360

Practitioners & affiliated clinicians

Practitioners 4

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1255365136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 BRADDOCK ROAD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 BRADDOCK ROAD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-333-6361",
            "fax_number": "703-333-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-10-28",
        "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": "VA",
            "license": "0201003052",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003052",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010023718",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4837704",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 249",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.