Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 335
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (MANAGER)
(617) 770-8782
Entity
Organization
Contact information
Practice address
1700 KINGFISHER DR, FREDERICK, MD 21701-4775
(301) 815-2201
(301) 815-2203
Mailing address
1700 KINGFISHER DR, FREDERICK, MD 21701-4775
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO4108
MD
333600000X
Pharmacy
PO4108
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO4108
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131807
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
406357100
—
MD
Enumeration date
07/09/2006
Last updated
04/11/2018
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