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Organization
NAI SATURN EASTERN LLC
Active
Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #2892
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
1100 4TH ST SW STE 150, WASHINGTON, DC 20024-4469
(202) 719-2500
(202) 719-2504
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(847) 916-4463
(847) 916-4736
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RX0000077
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149953
PK
—
Enumeration date
03/18/2010
Last updated
09/27/2018
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