Organization
GIANT EAGLE INC
Active
Other names
GIANT EAGLE PHARMACY 6379
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KRASNOW (DIRECTOR MANAGED CARE)
(412) 968-1550
Entity
Organization
Contact information
Practice address
420 WATERFRONT DR E, HOMESTEAD, PA 15120-1143
(412) 462-5359
(412) 462-5389
Mailing address
101 KAPPA DR, PITTSBURGH, PA 15238-2809
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP415616L
PA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007285680138
—
PA
01
—
3976872
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
870021414
MEDICARE RAILRAOD FLU GIANT EAGLE PA
PA
Enumeration date
07/29/2006
Last updated
05/08/2009
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