Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 155
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
7200 CRADLEROCK WAY, COLUMBIA, MD 21045-5067
(410) 290-7013
(410) 381-3956
Mailing address
7200 CRADLEROCK WAY, COLUMBIA, MD 21045-5067
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO0288
MD
333600000X
Pharmacy
PO0288
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO0288
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110740
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
689704500
—
MD
Enumeration date
07/09/2006
Last updated
10/13/2011
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