Organization
GIANT OF MARYLAND LLC
Active
Other names
Giant Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
IRA KRESS (PRESIDENT)
(207) 885-2518
Entity
Organization
Contact information
Practice address
2425 CENTREVILLE RD, HERNDON, VA 20171-3013
(703) 689-2570
(703) 787-6863
Mailing address
PO BOX 1000, PORTLAND, ME 04104-5005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003046
VA
333600000X
Pharmacy
0201003046
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003046
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008514941
—
VA
01
—
4819566
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/09/2006
Last updated
03/25/2021
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