Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 368
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
842 MUDDY BRANCH RD, GAITHERSBURG, MD 20878-2780
(301) 926-2044
(301) 926-8487
Mailing address
842 MUDDY BRANCH RD, GAITHERSBURG, MD 20878-2780
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO1232
MD
333600000X
Pharmacy
PO1232
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO1232
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113760
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
694401900
—
MD
Enumeration date
07/11/2006
Last updated
11/17/2011
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