Healthcare Provider Details
I. General information
NPI: 1952314247
Provider Name (Legal Business Name): THE GIANT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2006
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
240 ELIZABETH DRIVE
STEPHENS CITY VA
22655
US
IV. Provider business mailing address
1149 HARRISBURG PIKE
CARLISLE PA
17013-1607
US
V. Phone/Fax
- Phone: 540-868-0663
- Fax:
- Phone: 717-240-1526
- Fax: 717-960-4226
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 0201004096 |
| License Number State | VA |
VIII. Authorized Official
Name:
LEIGH
SHIRLEY
Title or Position: VICE PRESIDENT PHARMACY
Credential: RPH
Phone: 717-240-1506