Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #0878
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
7900 FORT HUNT RD, ALEXANDRIA, VA 22308-1203
(703) 765-0540
(703) 660-5986
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
0201003087
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150026
PK
—
05
—
8545260
—
VA
Enumeration date
07/02/2006
Last updated
06/22/2020
Update your record
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