MEDICARE: THE GIANT COMPANY, 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	PP414951L	PA
2	3336C0003X	Community/Retail Pharmacy

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	3969106	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1003848011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GIANT COMPANY, LLC

Provider Business Mailing Address
First Line	:	1149 HARRISBURG PIKE
Second Line	:	ATTN: THIRD PARTY COORDINATOR
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	:	471 S OXFORD VALLEY RD
Second Line	:
City	:	FAIRLESS HILLS
State	:	PA
Zip	:	19030-4202
Country	:	US
Telephone Number	:	215-949-8955
Fax Number	:	215-949-8963

Authorized Official
Title or Position	:	SVP HEALTH & HOUSEHOLD
Name	:	RAYMOND HOOVER
Credential	:	RPH
Telephone Number	:	717-960-8553

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	11/20/2020

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Directions to “THE GIANT COMPANY, LLC ” Practice Location

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