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General NPI Number Information
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NPI Number | 1215133137
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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 | 06/26/2007
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 1385 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-5103
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Country | US
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Telephone | 617-770-6257
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Fax | 617-770-8671
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Provider Business Mailing Address
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Address Line | 1385 HANCOCK ST
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City | QUINCY
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State | MA
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Zip | 02169-5103
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Country | US
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Telephone | 617-770-6257
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Fax | 617-770-8671
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Authorized Official
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Title or Position | DIRECTOR THIRD PARTY
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Name | ROBERT STONE
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Credential |
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Telephone | 781-380-5609
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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 |
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License Number State |
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