Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 744
Organization subpart
No
Provider details
NPI number
Authorized official
BOB STONE (DIR 3RD PARTY AND MANAGED CARE)
(781) 380-5609
Entity
Organization
Contact information
Practice address
5740 UNION MILL RD, CLIFTON, VA 20124-1088
(703) 818-0589
(703) 818-2707
Mailing address
5740 UNION MILL RD, CLIFTON, VA 20124-1088
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201003063
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008543551
—
VA
01
—
4825824
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
07/01/2009
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