Organization
GIANT OF MARYLAND LLC
Active
Organization
GIANT OF MARYLAND LLC
Active
Other names
Giant Pharmacy #234
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8732
Entity
Organization
Contact information
Practice address
550 CELEBRATE VIRGINIA PKWY, FREDERICKSBURG, VA 22406-7292
(540) 286-1722
Mailing address
550 CELEBRATE VIRGINIA PKWY, FREDERICKSBURG, VA 22406-7292
(540) 286-1722
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201004138
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201004138
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558491993
—
VA
01
—
4839885
NCPDP
—
Enumeration date
03/06/2007
Last updated
10/13/2011
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