Organization Active NPI

Giant Eagle, Inc

Doing business as Giant Eagle Pharmacy #87

  • Community/Retail Pharmacy
  • Saint Marys, PA
National Provider Identifier
1386951705
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482060 Issued in PA
Legal business name
GIANT EAGLE, INC
Doing business as
Giant Eagle Pharmacy #87
Practice address
846 S Saint Marys St
Saint Marys, PA 15857-2831
Phone
(814) 781-1350
Fax
(814) 781-3418
NPI assigned
Sep 7, 2010
Last updated
Jan 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Ms. Debra B Krasnow, PHARMDNPI 1821286717
Title
Director of Managed Care
Phone
(412) 967-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PP482060 PA Primary

Addresses

Primary practice location

846 S Saint Marys St
Saint Marys, PA 15857-2831

Mailing address

101 Kappa Dr
Pittsburgh, PA 15238-2809
Phone (412) 968-1550

Other identifiers 1

IdentifierTypeStateIssuer
1007285680325MedicaidPA

Other names 1

  • Giant Eagle Pharmacy #87 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061213000490 PA Part B Supplier - Mass Immunization (Roster Biller Only) 8921083049 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1386951705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 KAPPA DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152382809",
            "telephone_number": "412-968-1550",
            "fax_number": "412-968-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 S SAINT MARYS ST",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158572831",
            "telephone_number": "814-781-1350",
            "fax_number": "814-781-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT EAGLE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "KRASNOW",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "412-967-1550",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007285680325",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giant Eagle Pharmacy #87",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.