NPI | 1639267891 |
---|---|
Doing Business As | GIANT PHARMACY #791 |
Entity Type | Organization |
Authorized Contact | BRAD DAYTON Director 617-770-8982 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VA 0201004105) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 201004105) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2011-10-20 |