Giant of Maryland LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RX8800113 Issued in DC

Legal business name

GIANT OF MARYLAND LLC

Practice address

1414 8TH St NW
Washington, DC 20001-3304

Phone

(202) 628-0577

Fax

(202) 232-3505

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 376 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1801829155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 8TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 8TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013304",
            "telephone_number": "202-628-0577",
            "fax_number": "202-232-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANT OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-11-17",
        "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": "DC",
            "license": "RX8800113",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "DC",
            "license": "RX8800113",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DC",
            "license": "RX8800113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020742700",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0902280",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIANT PHARMACY 376",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Lynn Giannotta, DMD
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Giant of Maryland LLC
• Mamusu Gibateh
• Andee Gibb, PHARMD
• Junette Gibbons, MD
• Kelly Kathleen Gibbons, MS, RD, LD

• Community/Retail Pharmacy in Washington, DC
• Providers in Washington, DC by specialty
• Community/Retail Pharmacy in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.