Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 324
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
4315 MOUNTAIN RD, PASADENA, MD 21122-4560
(410) 439-2104
(410) 439-2126
Mailing address
4315 MOUNTAIN RD, PASADENA, MD 21122-4560
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P03189
MD
333600000X
Pharmacy
P03189
MD
3336C0003X
Community/Retail Pharmacy
Primary
P03189
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127137
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
403745600
—
MD
Enumeration date
07/09/2006
Last updated
10/27/2011
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