Organization
GIANT OF MARYLAND LLC
Active
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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