Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 128
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
2145 YORK RD, LUTHERVILLE, MD 21093-3110
(410) 252-4217
(410) 252-5529
Mailing address
2145 YORK RD, LUTHERVILLE, MD 21093-3110
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO0267
MD
333600000X
Pharmacy
PO0267
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO0267
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2101335
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4169972 00
—
MD
Enumeration date
07/09/2006
Last updated
11/17/2011
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