Organization
NAI SATURN EASTERN LLC
Active
Other names
SAFEWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-6200
Mailing address
PO BOX 742382, LOS ANGELES, CA 90074-2382
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/04/2014
Last updated
04/24/2020
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