Provider Demographics
NPI:1659303667
Name:THE GIANT COMPANY, LLC
Entity Type:Organization
Organization Name:THE GIANT COMPANY, LLC
Other - Org Name:GIANT PHARMACY #6539
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKIEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-240-1526
Mailing Address - Street 1:1149 HARRISBURG PIKE
Mailing Address - Street 2:THIRD PARTY COORDINATOR
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-1607
Mailing Address - Country:US
Mailing Address - Phone:717-960-8553
Mailing Address - Fax:717-960-1389
Practice Address - Street 1:5005 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2922
Practice Address - Country:US
Practice Address - Phone:717-857-3329
Practice Address - Fax:717-671-6785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHOLD USA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-07
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414424L333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01833654Medicaid
PA1007302990139Medicaid
3962049OtherOTHER ID NUMBER-COMMERCIAL NUMBER
DE0001097907Medicaid
PA01833654Medicaid