Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #4832
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
5545 CONNECTICUT AVE NW, WASHINGTON, DC 20015-2606
(202) 364-0320
(202) 363-2840
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
RX0000082
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033618500
—
DC
01
—
2149954
PK
—
Enumeration date
06/21/2006
Last updated
09/27/2018
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