Giant of Maryland LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PO2279 Issued in MD

Legal business name

GIANT OF MARYLAND LLC

Doing business as

GIANT PHARMACY 317

Practice address

4624 Edmondson Ave
Baltimore, MD 21229-1407

Phone

(410) 362-1375

Fax

(410) 534-5190

NPI assigned

Jul 11, 2006

Organization subpart

Yes

Parent organization

AHOLD USAAs reported in NPPES

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

Authorized official

Name

Raymond McCall

Title

Third Party Coordinator

Phone

(717) 960-5666

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• GIANT PHARMACY 317 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dudley Alvin Demarest Jr., BPHARM, MBA, PHD

  • Pharmacist
  • Baltimore, MD
  • NPI 1023230943
  NPD (past)
• Roland Dang Vando

  • Pharmacist
  • Baltimore, MD
  • NPI 1821691940
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1679508634",
    "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": "4624 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291407",
            "telephone_number": "410-362-1375",
            "fax_number": "410-534-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHOLD USA",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "THIRD PARTY COORDINATOR",
        "authorized_official_telephone_number": "717-960-5666"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "PO2279",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO2279",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PO2279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2122834",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125548700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 317",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland, LLC
• Caelie Giapponi, CCC-SLP
• Francis M Giardiello, M.D.
• Giardina & Glubo DPM PA

• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.