Organization
GIANT FOOD STORES, LLC
Active
Parent organization
AHOLD USA INC
Other names
Martin's Pharmacy #6436
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLD USA INC
Authorized official
MRS. LEIGH SHIRLEY RPH (VICE PRESIDENT, PHARMACY)
(717) 240-1506
Entity
Organization
Contact information
Practice address
5700 BROOK RD, RICHMOND, VA 23227-2257
(804) 264-1597
(804) 261-4956
Mailing address
1149 HARRISBURG PIKE, CARLISLE, PA 17013-1607
(717) 240-1526
(717) 960-4226
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201002755
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201002755
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008530131
—
VA
01
—
09110585
MEDICAID DME
VA
01
—
4824808
NCPDP
VA
01
—
P00758645
MEDICARE FLU BILLING - RAIL ROAD
—
01
—
PHC089
MEDICARE B FLU BILLING
—
Enumeration date
06/06/2006
Last updated
03/07/2023
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