Giant Pharmacy 767

LBN: Giant Of Maryland Llc
Giant Pharmacy 767 is an health care organization with primary practice located at 10653 Braddock Rd , Fairfax VA 22032-2202. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Giant Of Maryland Llc can be contacted via phone (703) 591-0020, or through Dayton, Brad via phone (617) 770-8782.

Contact Information

Primary practice address
10653 Braddock Rd Fairfax VA 22032-2202
Fax: (703) 385-3848
Website:
Authorized official contact:
Name: Dayton, Brad

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 0201003039 Virginia
Suppliers / Pharmacy 333600000X 0201003039 Virginia
Suppliers / Community/Retail Pharmacy 3336C0003X 0201003039 Virginia

Profile Details

NPI number 1023041365
LBN Legal business name Giant Of Maryland Llc
DBA Doing business as Giant Pharmacy 767
Authorized official Dayton, Brad
Entity Organization
Organization subpart 1 No
Enumeration date Jul 9th, 2006
Last updated Oct 28th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023041365 NPPES
Other 4814201 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 008511233 OTHER ID NUMBER-COMMERCIAL NUMBER

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