GIANT PHARMACY 317
NPI 1679508634
Pharmacy - Community/Retail Pharmacy in Baltimore, MD

Q: What is Giant Of Maryland LLC's NPI number?

The NPI number for Giant Of Maryland LLC is 1679508634. It was assigned to this organization in the NPPES registry on July 11, 2006. The provider is doing business as Giant Pharmacy 317.

Q: What is Giant Of Maryland LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since July 11, 2006CLIA 21D2171663 · Waiver

4624 EDMONDSON AVE, BALTIMORE, MD 21229(410) 362-1375(410) 534-5190 Get Directions Write a Review

NPPES record last updated: June 9, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Giant Pharmacy 317 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GIANT PHARMACY 317 (NPI 1679508634) is a healthcare organization registered as a community/retail pharmacy in Baltimore, Maryland and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 5, 2027 and lists Raymond Mccall, Third Party Coordinator, as its authorized official.

NPPES Registry Identity

NPI1679508634

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameGIANT OF MARYLAND LLC

Location Address4624 EDMONDSON AVEBaltimore, MD 21229-1407

Mailing Address1149 Harrisburg Pike, Third Party CoordinatorCarlisle, PA 17013-1607 · (717) 960-8553 · Fax (717) 960-1389

Phone(410) 362-1375

Fax(410) 534-5190

Organization SubpartYesParent: Ahold Usa

Authorized OfficialRaymond MccallThird Party Coordinator · (717) 960-5666

Enumeration DateJuly 11, 2006

Last NPPES UpdateJune 9, 2017

✔ NPI 1679508634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MD · PO2279

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License PO2279 (MD)

Also ListedPharmacyTaxonomy 333600000X · License PO2279 (MD)

4624 EDMONDSON AVE, Baltimore, MD 21229

Open in Google Maps ↗

Other Names 1

Doing Business AsGiant Pharmacy 317

Other Identifiers 3

Medicaid125548700MD

Medicare NSC4081710005MD

Other2122834Other Id Number-commercial Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2171663

Giant Pharmacy #317 · Baltimore, MD

Active · expires Sep 5, 2027

CLIA Number21D2171663

Laboratory TypePharmacy

Certificate Effective DateSeptember 6, 2025

Certificate Expiration DateSeptember 5, 2027

Laboratory DirectorDudley Demarest

Laboratory Phone(410) 362-1375

Laboratory LocationGiant Pharmacy #3174624 Edmondson Avenue, Baltimore, MD 21229

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DUDLEY ALVIN DEMAREST JR. BPHARM, MBA, PHD

Pharmacist

4624 EDMONDSON AVE
BALTIMORE, MD 21229

Baltimore City (410) 362-1375

ROLAND DANG VANDO

Pharmacist

4624 EDMONDSON AVE
BALTIMORE, MD 21229

Baltimore City (410) 362-1375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Giant Of Maryland LLC's NPI number?

The NPI number for Giant Of Maryland LLC is 1679508634. It was assigned to this organization in the NPPES registry on July 11, 2006. The provider is doing business as Giant Pharmacy 317.

Where is Giant Of Maryland LLC located?

Giant Of Maryland LLC is located at 4624 Edmondson Ave, Baltimore, MD 21229. The listed phone number is (410) 362-1375.

What is Giant Of Maryland LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Giant Of Maryland LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2171663) is associated with this NPI, valid through September 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Giant Of Maryland LLC accept?

Health plans from Medica and Moda Health Plan, Inc. list Giant Of Maryland LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Giant Of Maryland LLC was last updated on June 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.