Organization
NAI SATURN EASTERN LLC
Active
Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #1763
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
190 JOHN HUNN BROWN RD, DOVER, DE 19901-4708
(302) 730-9101
(302) 730-3756
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
A3-0000973
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001145907
—
DE
01
—
2149940
PK
—
Enumeration date
06/21/2006
Last updated
09/27/2018
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