Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 150
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
46 BUREAU DR, GAITHERSBURG, MD 20878-1402
(301) 840-0815
(301) 590-0845
Mailing address
46 BUREAU DR, GAITHERSBURG, MD 20878-1402
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO0284
MD
333600000X
Pharmacy
PO0284
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO0284
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110245
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
690006200
—
MD
Enumeration date
07/09/2006
Last updated
10/13/2011
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