Organization
GIANT OF MARYLAND LLC
Active
Other names
SUPER G PHARMACY 386
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON FARRELL (DIRECTOR, PHARMACY THIRD PARTY)
(717) 240-1526
Entity
Organization
Contact information
Practice address
4301 CONCORD PIKE, WILMINGTON, DE 19803-1461
(302) 475-6572
(302) 477-5190
Mailing address
1149 HARRISBURG PIKE, CARLISLE, PA 17013-1607
(717) 240-5520
(717) 960-8371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
A30000593
DE
333600000X
Pharmacy
A30000593
DE
3336C0003X
Community/Retail Pharmacy
Primary
A30000593
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000647507
—
DE
01
—
0803228
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
10/04/2013
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