Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 227
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTO (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
10100 DUMFRIES RD, MANASSAS, VA 20110-7951
(703) 331-2320
(703) 331-2390
Mailing address
10100 DUMFRIES RD, MANASSAS, VA 20110-7951
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003271
VA
333600000X
Pharmacy
0201003271
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003271
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008507104
—
VA
01
—
4829113
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
09/23/2011
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