GIANT EAGLE PHARMACY 4078 – Community/Retail Pharmacy, NPI 1790790608

GIANT EAGLE PHARMACY 4078 is a healthcare provider. based in Pittsburgh, Pennsylvania. specializing in Community/Retail Pharmacy. The organization holds a License No. 020554850 (OH). The NPI Number for GIANT EAGLE PHARMACY 4078 is 1790790608

Main info

Organization
Name
GIANT EAGLE PHARMACY 4078
NPI
1790790608
Phone
Not provided
Address
101 KAPPA DR
Authorized Official
DEBORAH J ELMS INSURANCE CONTRACTING & CREDENTIALI
Enumeration Date
29 July 2006
Last Update Date
17 June 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for GIANT EAGLE PHARMACY 4078

  • Kappa Alley, Regent Square, Pittsburgh, Allegheny County, Pennsylvania, 15218, United States

    PITTSBURGH, PA 152382809

    Phone:

    Type: Mailing

  • Giant Eagle, 5220, Mahoning Avenue, Youngstown, Mahoning County, Ohio, 44515, United States

    YOUNGSTOWN, OH 445151806

    Phone: (330) 793-9345

    Fax: (330) 793-8659

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (589 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930026898OPharmacyOH2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine194193$0
90480Admn sarscov2 vacc 1 dose143143$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage143143$0
91322Sarscov2 vac 50 mcg/0.5ml im7979$0
91320Sarscv2 vac 30mcg trs-suc im6464$0
View full utilization report →

Insurance plans in this area (ZIP 15238)

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Reviews

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Frequently asked questions

What NPI should I save for GIANT EAGLE PHARMACY 4078?
Save NPI 1790790608 if you need a stable reference for GIANT EAGLE PHARMACY 4078.
Is GIANT EAGLE PHARMACY 4078 active in the national directory?
GIANT EAGLE PHARMACY 4078's public NPI profile is in an active state.
What kind of provider is GIANT EAGLE PHARMACY 4078?
The page reflects Community/Retail Pharmacy for GIANT EAGLE PHARMACY 4078. Clinical services aligned with this taxonomy classification.
What location shows for GIANT EAGLE PHARMACY 4078?
We surface Pittsburgh, Pennsylvania for GIANT EAGLE PHARMACY 4078 based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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