NPIMap

Organization Active NPI

Giant of Maryland LLC

  • Community/Retail Pharmacy
  • Sterling, VA
National Provider Identifier
1821021171
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201003211 Issued in VA
Legal business name
GIANT OF MARYLAND LLC
Practice address
21000 Southbank St Ste 150
Sterling, VA 20165-7242
Phone
(703) 430-0400
Fax
(703) 421-1190
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Authorized official

Name
Bob Stone
Title
Dir 3Rd Party and Managed Care
Phone
(617) 770-6257

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0201003211 VA
Pharmacy 333600000X 0201003211 VA
Community/Retail Pharmacy 3336C0003X 0201003211 VA Primary

Addresses

Primary practice location

21000 Southbank St Ste 150
Sterling, VA 20165-7242

Mailing address

21000 Southbank St Ste 150
Sterling, VA 20165-7242

Other identifiers 2

IdentifierTypeStateIssuer
4828426OtherOTHER ID NUMBER-COMMERCIAL NUMBER
008504954MedicaidVA

Other names 1

  • GIANT PHARMACY 794 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
O20100930030990 VA DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Sterling, 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
49D2200616Giant Pharmacy #79421000 Southbank St Suite 150, Sterling, VA 20165Certificate of waiverNov 16, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Giant Pharmacy #79421000 Southbank St 150, Sterling, VA 20165-7242(703) 430-0400 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 21

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

View all 21

Locations

21000 Southbank St
Ste 150
Sterling, VA 20165
Phone (703) 430-0400

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": "1243468800000",
    "number": "1821021171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 SOUTHBANK ST STE 150",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 SOUTHBANK ST STE 150",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201657242",
            "telephone_number": "703-430-0400",
            "fax_number": "703-421-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "DIR 3RD PARTY AND MANAGED CARE",
        "authorized_official_telephone_number": "617-770-6257"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201003211",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003211",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4828426",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008504954",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 794",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.