Provider Demographics
NPI:1366552861
Name:GIANT EAGLE, INC
Entity type:Organization
Organization Name:GIANT EAGLE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY CONTRACTING
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:412-967-3718
Mailing Address - Street 1:101 KAPPA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2833
Mailing Address - Country:US
Mailing Address - Phone:412-967-4775
Mailing Address - Fax:412-968-1727
Practice Address - Street 1:300 TRI COUNTY LANE
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1990
Practice Address - Country:US
Practice Address - Phone:724-929-3789
Practice Address - Fax:724-929-6034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP-4816163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA870021414OtherMEDICARE RAILROAD FLU GIANT EAGLE PA
PA1007285680310Medicaid
PA1007285680310Medicaid
PA870021414OtherMEDICARE RAILROAD FLU GIANT EAGLE PA