Organization
GIANT OF MARYLAND LLC
Active
Other names
GIANT PHARMACY 146
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD DAYTON (DIRECTOR)
(617) 770-8782
Entity
Organization
Contact information
Practice address
655 SOLOMONS ISLAND RD N, PRINCE FREDERICK, MD 20678-3915
(410) 535-5974
(410) 269-5728
Mailing address
655 SOLOMONS ISLAND RD N, PRINCE FREDERICK, MD 20678-3915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PO1658
MD
333600000X
Pharmacy
PO1658
MD
3336C0003X
Community/Retail Pharmacy
Primary
PO1658
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117984
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
695903200
—
MD
Enumeration date
07/09/2006
Last updated
10/13/2011
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