Organization
GIANT OF MARYLAND LLC
Active
Other names
Giant Pharmacy #301
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
13781 CONNECTICUT AVE, SILVER SPRING, MD 20906-2916
(781) 380-5611
Mailing address
13781 CONNECTICUT AVE, SILVER SPRING, MD 20906-2916
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO4658
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO4658
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154300 00
—
MD
Enumeration date
08/30/2007
Last updated
10/28/2011
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