Organization
NAI SATURN EASTERN LLC
Active
Other names
SAFEWAY PHARMACY #3217
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
415 14TH ST SE, WASHINGTON, DC 20003-3002
(202) 547-4350
(202) 547-2201
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
RX0000080
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033586100
—
DC
01
—
2149951
PK
—
Enumeration date
06/21/2006
Last updated
07/06/2020
Update your record
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