Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 362
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
20944 FREDERICK RD, GERMANTOWN, MD 20876-4101
(301) 515-9498
(301) 601-6190
Mailing address
20944 FREDERICK RD, GERMANTOWN, MD 20876-4101
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO2126
MD
333600000X
Pharmacy
PO2126
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO2126
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122137
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
696602100
—
MD
Enumeration date
07/11/2006
Last updated
11/17/2011
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