Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 197
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
7944 HONEYGO BLVD, BALTIMORE, MD 21236-4919
(410) 931-7533
(410) 931-7531
Mailing address
7944 HONEYGO BLVD, BALTIMORE, MD 21236-4919
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4081710074
MD
333600000X
Pharmacy
PO1442
MD
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116071
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
696404400
—
MD
Enumeration date
07/11/2006
Last updated
09/23/2011
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