Healthcare Provider Details

I. General information

NPI: 1104858117
Provider Name (Legal Business Name): THE GIANT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 UPLAND SQ DR
STOWE PA
19464-9432
US

IV. Provider business mailing address

1149 HARRISBURG PIKE
CARLISLE PA
17013-1607
US

V. Phone/Fax

Practice location:
  • Phone: 610-705-0004
  • Fax: 610-705-0007
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP414228L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LEIGH SHIRLEY
Title or Position: VICE PRESIDENT PHARMACY
Credential:
Phone: 717-240-1506