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General NPI Number Information
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NPI Number | 1003841057
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Entity Type | Organization
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Legal Business Name | GIANT OF MARYLAND LLC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 20044 GOSHEN RD
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City | GAITHERSBURG
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State | MD
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Zip | 20879-1604
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Country | US
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Telephone | 301-990-0627
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Fax | 301-926-8661
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Provider Business Mailing Address
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Address Line | 20044 GOSHEN RD
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City | GAITHERSBURG
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State | MD
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Zip | 20879-1604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BRAD DAYTON
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Credential |
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Telephone | 617-770-8782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PO1411
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO1411
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PO1411
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License Number State | MD
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