Organization
GIANT OF MARYLAND LLC
Active
Parent organization
AHOLD USA
Other names
GIANT PHARMACY 375
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLD USA
Authorized official
GAYLE SHIELDS RPH (VP)
(301) 957-5004
Entity
Organization
Contact information
Practice address
1050 BRENTWOOD RD NE, WASHINGTON, DC 20018-1000
(202) 281-3901
(202) 281-3903
Mailing address
1149 HARRISBURG PIKE, THIRD PARTY COORDINATOR, CARLISLE, PA 17013-1607
(717) 960-8553
(717) 960-1389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RX0200327
DC
333600000X
Pharmacy
RX0200327
DC
3336C0003X
Community/Retail Pharmacy
Primary
RX0200327
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904311
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
400350100
—
DC
Enumeration date
07/09/2006
Last updated
11/29/2016
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