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General NPI Number Information
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NPI Number | 1073707337
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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 | 08/30/2007
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 13781 CONNECTICUT AVE
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City | SILVER SPRING
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State | MD
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Zip | 20906-2916
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Country | US
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Telephone | 781-380-5611
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Fax |
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Provider Business Mailing Address
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Address Line | 13781 CONNECTICUT AVE
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City | SILVER SPRING
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State | MD
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Zip | 20906-2916
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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 | DIRECTOR
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO4658
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PO4658
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License Number State | MD
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