Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 304
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
3297 CRAIN HIGHWAY, WALDORF, MD 20603
(301) 542-4200
(301) 542-4190
Mailing address
3297 CRAIN HIGHWAY, WALDORF, MD 20603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P04069
MD
333600000X
Pharmacy
P04069
MD
3336C0003X
Community/Retail Pharmacy
Primary
P04069
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127466
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
404977200
—
MD
Enumeration date
07/09/2006
Last updated
10/28/2011
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