Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 778
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
41 W LEE HWY STE 27, WARRENTON, VA 20186-2200
(540) 347-1078
(540) 349-3125
Mailing address
41 W LEE HWY STE 27, WARRENTON, VA 20186-2200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003051
VA
333600000X
Pharmacy
0201003051
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003051
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008515484
—
VA
01
—
4820191
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
05/28/2009
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