MEDICARE: GIANT EAGLE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	021233850	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	870021414	OTHER	OH	MEDICARE RAILROAD FLU 6502B

General Provider Information

NPI Number	:	1578702460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIANT EAGLE INC

Provider Business Mailing Address
First Line	:	101 KAPPA DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2809
Country	:	US
Telephone Number	:	412-968-1550
Fax Number	:	412-968-1727

Provider Business Practice Location Address
First Line	:	1000 E DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2503
Country	:	US
Telephone Number	:	614-416-0381
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF MANAGED CARE
Name	:	DEBRA B KRASNOW
Credential	:	PHARM.D.
Telephone Number	:	412-968-1550

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	02/18/2009

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Directions to “GIANT EAGLE INC ” Practice Location

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