NPIMap

Organization Active NPI

Giant of Maryland LLC

Doing business as Giant Pharmacy 779

  • Community/Retail Pharmacy
  • Manassas, VA
National Provider Identifier
1831122175
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0201003033 Issued in VA
Legal business name
GIANT OF MARYLAND LLC
Doing business as
Giant Pharmacy 779
Practice address
8025 Sudley Rd
Manassas, VA 20109-8001
Phone
(703) 361-9210
Fax
(703) 369-5108
NPI assigned
Jul 9, 2006
Last updated
Feb 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 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 0201003033 VA
Pharmacy 333600000X 0201003033 VA
Community/Retail Pharmacy 3336C0003X 0201003033 VA Primary

Addresses

Primary practice location

8025 Sudley Rd
Manassas, VA 20109-8001

Mailing address

8025 Sudley Rd
Manassas, VA 20109-8001

Other identifiers 2

IdentifierTypeStateIssuer
008514232MedicaidVA
4818134OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • GIANT PHARMACY 779 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
O20100930066562 VA DME Supplier - PharmacyDME Supplier - Grocery Store 7113914219 Practice locations: Manassas, VA

National Provider Directory

National Provider Directory
Tax ID family
Giant of Maryland LLC162 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1233878400000",
    "number": "1831122175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201098001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201098001",
            "telephone_number": "703-361-9210",
            "fax_number": "703-369-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-02-06",
        "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": "0201003033",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003033",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008514232",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4818134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 779",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.