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General NPI Number Information
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NPI Number | 1366475618
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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 | 07/09/2006
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 300 EDEN CIR
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City | BEAR
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State | DE
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Zip | 19701-4303
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Country | US
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Telephone | 302-832-0156
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Fax | 302-832-5190
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Provider Business Mailing Address
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Address Line | PO BOX 1000 MS 3000
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City | PORTLAND
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State | ME
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Zip | 04104-5005
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Country | US
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Telephone | 207-885-7454
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Fax | 704-645-6531
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRA KRESS
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Credential |
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Telephone | 207-885-7454
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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 | A30000582
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | A30000582
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License Number State | DE
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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 | A30000582
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License Number State | DE
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