Giant of Maryland LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PO0285 Issued in MD

Legal business name

GIANT OF MARYLAND LLC

Practice address

2401 Wootton Pkwy
Rockville, MD 20850-3031

Phone

(301) 762-5366

Fax

(301) 762-5952

NPI assigned

Jul 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brad Dayton

Title

Director

Phone

(617) 770-8782

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• GIANT PHARMACY 151 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1063445310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 WOOTTON PKWY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 WOOTTON PKWY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503031",
            "telephone_number": "301-762-5366",
            "fax_number": "301-762-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "DAYTON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-770-8782"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "PO0285",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "PO0285",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "PO0285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2110360",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689905600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 151",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amere Lashaye Gholson
• Kerniba Yohi Ghoneim, DNP, APRN, PMHNP-BC
• Namita Jaisingh Ghorpade, PT
• Mahashweta Rita Ghosh, M.D.
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Dana Gibbons
• Traneshia Gibbons

• Community/Retail Pharmacy in Rockville, MD
• Providers in Rockville, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.