Provider Demographics
NPI:1861685661
Name:THE GIANT COMPANY, LLC
Entity Type:Organization
Organization Name:THE GIANT COMPANY, LLC
Other - Org Name:MARTIN'S PHARMACY #6424
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-240-1506
Mailing Address - Street 1:1149 HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-1607
Mailing Address - Country:US
Mailing Address - Phone:717-240-1543
Mailing Address - Fax:717-960-4861
Practice Address - Street 1:2035 E MARKET ST STE 115
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8881
Practice Address - Country:US
Practice Address - Phone:540-442-7380
Practice Address - Fax:540-442-8089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHOLD USA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-24
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010041813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861685661Medicaid
4840369OtherNCPDP
VA1861685661Medicaid