NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Edgewater, MD
National Provider Identifier
1417980764
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PO0290 Issued in MD
Legal business name
GIANT OF MARYLAND LLC
Doing business as
Giant Pharmacy #308
Practice address
13 Lee Airport Road
Edgewater, MD 21037
Phone
(410) 956-4150
Fax
(410) 956-3098
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Alison Farrell
Title
Director, Pharmacy Third Party
Phone
(717) 240-1526

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PO0290 MD
Pharmacy 333600000X PO0290 MD
Community/Retail Pharmacy 3336C0003X PO0290 MD Primary

Addresses

Primary practice location

13 Lee Airport Road
Edgewater, MD 21037

Mailing address

1149 Harrisburg Pike
Carlisle, PA 17013-1607
Phone (717) 240-5520

Other identifiers 2

IdentifierTypeStateIssuer
689504200MedicaidMD
2111350OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Giant Pharmacy #308 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
O20100930016207 MD DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Edgewater, 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
21D2088539Giant Pharmacy #30813 Lee Airport Road, Edgewater, MD 21037Certificate of waiverDec 15, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #30813 Lee Airpark Dr, Edgewater, MD 21037-1237(410) 956-4150 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": "1419206400000",
    "number": "1417980764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HARRISBURG PIKE",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170131607",
            "telephone_number": "717-240-5520",
            "fax_number": "717-960-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 LEE AIRPORT ROAD",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "21037",
            "telephone_number": "410-956-4150",
            "fax_number": "410-956-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "DIRECTOR, PHARMACY THIRD PARTY",
        "authorized_official_telephone_number": "717-240-1526"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "PO0290",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO0290",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PO0290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689504200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2111350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giant Pharmacy #308",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.