Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Falls Church, VA
National Provider Identifier
1396778635
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201003049 Issued in VA
Legal business name
GIANT OF MARYLAND LLC
Practice address
3480 S Jefferson St
Falls Church, VA 22041-3104
Phone
(703) 931-1333
Fax
(703) 933-6190
NPI assigned
Jul 9, 2006
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 0201003049 VA
Pharmacy 333600000X 0201003049 VA
Community/Retail Pharmacy 3336C0003X 0201003049 VA Primary

Addresses

Primary practice location

3480 S Jefferson St
Falls Church, VA 22041-3104

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
008509204MedicaidVA
4802662OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • GIANT PHARMACY 780 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
O20100930028683 VA DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Falls Church, 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
49D2187272Giant Pharmacy #7803480 S Jefferson Street, Falls Church, VA 22041Certificate of waiverJun 28, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #7803480 S Jefferson St, Falls Church, VA 22041-3104(703) 931-1333 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

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": "1497830400000",
    "number": "1396778635",
    "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": "3480 S JEFFERSON ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413104",
            "telephone_number": "703-931-1333",
            "fax_number": "703-933-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHOLD USA",
        "enumeration_date": "2006-07-09",
        "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": "VA",
            "license": "0201003049",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003049",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008509204",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4802662",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 780",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falls Church, VA

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.