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Organization

GIANT FOOD STORES, LLC

Active
Parent organization
AHOLD USA INC
Other names
Martin's Pharmacy #6433
Organization subpart
Yes

Provider details

NPI number
Legal business name
AHOLD USA INC
Authorized official
ALISON FARRELL (DIRECTOR, PHARMACY THIRD PARTY)
(717) 240-1526
Entity
Organization

Contact information

Practice address
10250 STAPLES MILL RD, GLEN ALLEN, VA 23060-3064
(804) 755-6207
(804) 755-7166
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
0201003948
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003948
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010033012
VA
01
4837867
NCPDP
VA
01
P00758645
MEDICARE RAILROAD - FLU BILLING
01
PHC089
MEDICARE B - FLU BILLING
Enumeration date
06/06/2006
Last updated
03/07/2023
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