Organization
GIANT OF MARYLAND LLC
Active
Parent organization
AHOLDUSA
Other names
GIANT PHARMACY 2310
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHOLDUSA
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
9200 BALTIMORE NATIONAL PIKE, SUITE A, ELLICOTT CITY, MD 21042-2613
(410) 461-3178
(410) 461-6127
Mailing address
1149 HARRISBURG PIKE, THIRD PARTY COORDINATOR, CARLISLE, PA 17013-1607
(717) 960-8553
(717) 960-1389
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO0275
MD
333600000X
Pharmacy
PO0275
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO0275
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2102325
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
690506400
—
MD
Enumeration date
07/09/2006
Last updated
05/27/2016
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