MEDICARE: GIANT OF MARYLAND LLC

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	333600000X	Pharmacy	PO2557	MD
2	332B00000X	Durable Medical Equipment & Medical Supplies	PO2557	MD
3	3336C0003X	Community/Retail Pharmacy	PO2557	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2124737	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1588699540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIANT OF MARYLAND LLC

Provider Business Mailing Address
First Line	:	1149 HARRISBURG PIKE
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17013-1607
Country	:	US
Telephone Number	:	717-240-5520
Fax Number	:	717-960-8371

Provider Business Practice Location Address
First Line	:	751 S SALISBURY BLVD
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21801-5812
Country	:	US
Telephone Number	:	443-260-2400
Fax Number	:	443-260-2412

Authorized Official
Title or Position	:	DIRECTOR, PHARMACY THIRD PARTY
Name	:	ALISON FARRELL
Credential	:
Telephone Number	:	717-240-5520

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	10/04/2013

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Directions to “GIANT OF MARYLAND LLC ” Practice Location

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