Organization
GIANT OF MARYLAND LLC
Active
Other names
Giant Pharmacy #235
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8732
Entity
Organization
Contact information
Practice address
5701 PLANK RD, FREDERICKSBURG, VA 22407-6227
(781) 380-5611
(781) 380-5617
Mailing address
5701 PLANK ROAD, WEST FREDERICKBURG, VA 22407
(781) 380-5611
(781) 380-5617
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316137516
—
VA
01
—
4840319
NCPDP
VA
Enumeration date
07/25/2007
Last updated
10/13/2011
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