Organization
GIANT EAGLE INC
Active
Other names
GIANT EAGLE PHARMACY 2402
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KRASNOW PHARMD (DIRECTOR MANAGED CARE)
(412) 968-1550
Entity
Organization
Contact information
Practice address
4192 GLADES PIKE, SOMERSET, PA 15501-8724
(814) 443-3512
(724) 733-0691
Mailing address
101 KAPPA DR, PITTSBURGH, PA 15238-2809
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP414419L
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007285680064
—
PA
01
—
3961869
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
870021414
MEDICARE RAILROAD FLU GIANT EAGLE PA
PA
Enumeration date
07/29/2006
Last updated
05/07/2009
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