Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #1758
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
9645 BELAIR RD, PERRY HALL, MD 21128
(410) 256-6423
(410) 256-3765
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06620
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149995
PK
—
05
—
647502700
—
MD
Enumeration date
07/02/2006
Last updated
05/24/2022
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