Provider Demographics
NPI:1932650926
Name:THE GIANT COMPANY, LLC
Entity Type:Organization
Organization Name:THE GIANT COMPANY, LLC
Other - Org Name:GIANT PHARMACY 6534
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP HEALTH & HOUSEHOLD
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-960-5666
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 1:4930 EDGEMONT AVE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015
Practice Address - Country:US
Practice Address - Phone:610-245-2155
Practice Address - Fax:610-876-6369
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHOLD USA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-14
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3910690164Medicare NSC