Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #1657
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
10335 REISTERSTOWN RD, OWINGS MILLS, MD 21117-3990
(410) 998-3823
(410) 998-3827
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06614
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149987
PK
—
05
—
654128300
—
MD
Enumeration date
07/02/2006
Last updated
09/27/2018
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