Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #1596
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2644 CHAPEL LAKE DR, GAMBRILLS, MD 21054-1637
(410) 451-4775
(410) 451-4473
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-6200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06610
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149991
PK
—
05
—
423459600
—
MD
Enumeration date
06/21/2006
Last updated
11/03/2025
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