Organization
NAI SATURN EASTERN LLC
Active
Other names
SAFEWAY PHARMACY #3274
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENT MGR)
(208) 395-3954
Entity
Organization
Contact information
Practice address
3702 EAST-WEST HIGHWAY, HYATTSVILLE, MD 20782-2013
(301) 955-1943
(301) 955-1944
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(208) 395-3920
(623) 282-3834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P06957
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155212
PK
—
05
—
874071200
—
MD
Enumeration date
11/10/2015
Last updated
12/31/2021
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