NPI Record of MARTINS PHARMACY #6297 (THE GIANT COMPANY, LLC) NPI 1558393553

Pharmacy (Community/Retail Pharmacy) in Lavale, MD

Complete NPI Record

Field Name Value Definition
NPI1558393553The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameTHE GIANT COMPANY, LLCThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameMARTINS PHARMACY #6297Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address1149 HARRISBURG PIKEThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameCARLISLEThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NamePAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code170131607The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address12101 WINCHESTER RDThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLAVALEThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMDThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code215027688The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number3017293028The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017293534The fax number associated with the location address of the provider being identified.
Provider Enumeration Date7/7/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date11/23/2020The date that a record was last updated or changed.
Authorized Official Last NameSHIRLEYThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameLEIGHThe first name of the authorized official.
Authorized Official Title or PositionVICE PRESIDENT PHARMACYThe title or position of the authorized official.
Authorized Official Telephone Number7172401506The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1333600000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1P02327The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1MDThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1N
Healthcare Provider Taxonomy Code 23336C0003X
Healthcare Provider Primary Taxonomy Switch 2Y
Other Provider Identifier 12123379Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1OTHER ID NUMBER-COMMERCIAL NUMBER
Other Provider Identifier 23810007693Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 205Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2WV
Other Provider Identifier 3406671500Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 305Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3MD
Is Organization SubpartY
Parent Organization LBNAHOLD USA INC
Parent Organization TINUNAVAIL
NPI Certification Date11/23/2020