Organization
NAI SATURN EASTERN LLC
Active
Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #2781
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
11201 GEORGIA AVE, SILVER SPRING, MD 20902-4617
(301) 933-4684
(301) 933-8953
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06635
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150018
PK
—
05
—
621015500
—
MD
Enumeration date
09/13/2013
Last updated
01/08/2019
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