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	PO0276	MD
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2103163	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1518990860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIANT OF MARYLAND LLC

Provider Business Mailing Address
First Line	:	1901 PULASKI HWY
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-1611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 PULASKI HWY
Second Line	:
City	:	EDGEWOOD
State	:	MD
Zip	:	21040-1611
Country	:	US
Telephone Number	:	410-676-1400
Fax Number	:	410-676-5002

Authorized Official
Title or Position	:	DIR 3RD PARTY AND MANAGED CARE
Name	:	BOB STONE
Credential	:
Telephone Number	:	781-380-5609

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	09/11/2025

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Directions to “GIANT OF MARYLAND LLC ” Practice Location

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