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Organization

NAI SATURN EASTERN LLC

Active
Other names
Safeway Pharmacy #1565
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY ELIOPULOS (ASST., MGR)
(208) 395-3906
Entity
Organization

Contact information

Practice address
15411 NEW HAMPSHIRE AVE, SILVER SPRING, MD 20905-4162
(301) 476-8303
(301) 476-8307
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
P06608
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2149992
PK
05
423455300
MD
Enumeration date
06/21/2006
Last updated
02/28/2019
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