Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 786
Organization subpart
No
Provider details
NPI number
Authorized official
BOB STONE (DIR 3RD PARTY AND MANAGED CARE)
(617) 770-6257
Entity
Organization
Contact information
Practice address
220 ZAN RD, CHARLOTTESVILLE, VA 22901-2859
(434) 973-0776
(804) 974-7521
Mailing address
220 ZAN RD, CHARLOTTESVILLE, VA 22901-2859
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003053
VA
333600000X
Pharmacy
0201003053
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003053
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008515735
—
VA
01
—
4820482
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
05/28/2009
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