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	PO1732	MD
2	332B00000X	Durable Medical Equipment & Medical Supplies	PO1732	MD
3	3336C0003X	Community/Retail Pharmacy	PO1732	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2118607	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679506927
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	:	717-960-8553
Fax Number	:	717-960-1389

Provider Business Practice Location Address
First Line	:	7546 ANNAPOLIS RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1702
Country	:	US
Telephone Number	:	301-577-6128
Fax Number	:	301-577-6055

Authorized Official
Title or Position	:	SVP OF HEALTH & HOUSEHOLD
Name	:	RAYMOND MCCALL
Credential	:	RPH
Telephone Number	:	717-960-5666

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	04/28/2017

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Directions to “GIANT OF MARYLAND LLC ” Practice Location

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