Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 348
Organization subpart
No
Provider details
NPI number
Authorized official
BOB STONE (DIR 3RD PARTY AND MANAGED CARE)
(781) 380-5609
Entity
Organization
Contact information
Practice address
6050 DAYBREAK CIR, CLARKSVILLE, MD 21029-1641
(410) 531-7837
(410) 531-8190
Mailing address
6050 DAYBREAK CIR, CLARKSVILLE, MD 21029-1641
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO2125
MD
333600000X
Pharmacy
PO2125
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO2125
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122125
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
695703000
—
MD
Enumeration date
07/09/2006
Last updated
05/13/2009
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