NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Washington, DC
National Provider Identifier
1629001979
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RX0200327 Issued in DC
Legal business name
GIANT OF MARYLAND LLC
Practice address
1050 Brentwood Rd NE
Washington, DC 20018-1000
Phone
(202) 281-3901
Fax
(202) 281-3903
NPI assigned
Jul 9, 2006
Organization subpart
Yes
Parent organization
AHOLD USAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Authorized official

Name
Gayle Shields, RPH
Title
VP
Phone
(301) 957-5004

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X RX0200327 DC
Pharmacy 333600000X RX0200327 DC
Community/Retail Pharmacy 3336C0003X RX0200327 DC Primary

Addresses

Primary practice location

1050 Brentwood Rd NE
Washington, DC 20018-1000

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
400350100MedicaidDC
0904311OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • GIANT PHARMACY 375 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DC2 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
O20100930009429 DC DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Washington, DC

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
09D2232860Giant Pharmacy #3751050 Brentwood Road, NE, Washington, DC 20018Certificate of waiverAug 17, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant of Maryland LLC1050 Brentwood Rd NE, Washington, DC 20018-1000(202) 281-3901 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 4

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1629001979",
    "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",
            "fax_number": "717-960-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 BRENTWOOD RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181000",
            "telephone_number": "202-281-3901",
            "fax_number": "202-281-3903"
        }
    ],
    "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": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "301-957-5004",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "DC",
            "license": "RX0200327",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "DC",
            "license": "RX0200327",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DC",
            "license": "RX0200327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400350100",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0904311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 375",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.