Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 346
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
5316 NEW DESIGN RD, FREDERICK, MD 21703-7102
(301) 698-9430
(301) 360-2190
Mailing address
5316 NEW DESIGN RD, FREDERICK, MD 21703-7102
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO2207
MD
333600000X
Pharmacy
PO2207
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO2207
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122187
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
697701400
—
MD
Enumeration date
07/09/2006
Last updated
10/13/2011
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