Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 797
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
44110 ASHBURN UNIT 160, ASHBURN, VA 20147
(703) 729-3878
(703) 729-1190
Mailing address
44110 ASHBURN UNIT 160, ASHBURN, VA 20147
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003215
VA
333600000X
Pharmacy
0201003215
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003215
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008505683
—
VA
01
—
4828553
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
10/20/2011
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