Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 300
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
8805 CENTRE PARK DR, COLUMBIA, MD 21045-2117
(443) 364-5181
(443) 364-5190
Mailing address
8805 CENTRE PARK DR, COLUMBIA, MD 21045-2117
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
P03172
MD
333600000X
Pharmacy
P03172
MD
3336C0003X
Community/Retail Pharmacy
Primary
P03172
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127113
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
403425200
—
MD
Enumeration date
07/11/2006
Last updated
10/28/2011
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