Organization
GIANT OF MARYLAND LLC
Active
Parent organization
AHOLD USA
Other names
GIANT PHARMACY 317
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLD USA
Authorized official
RAYMOND MCCALL (THIRD PARTY COORDINATOR)
(717) 960-5666
Entity
Organization
Contact information
Practice address
4624 EDMONDSON AVE, BALTIMORE, MD 21229-1407
(410) 362-1375
(410) 534-5190
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
PO2279
MD
333600000X
Pharmacy
PO2279
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO2279
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125548700
—
MD
01
—
2122834
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
06/09/2017
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