Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 231
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
2932 CHAIN BRIDGE RD, OAKTON, VA 22124-3001
(703) 255-3484
(703) 281-6223
Mailing address
2932 CHAIN BRIDGE RD, OAKTON, VA 22124-3001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003035
VA
333600000X
Pharmacy
0201003035
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003035
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008513091
—
VA
01
—
4816887
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
10/28/2011
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