Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #4872
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
6235 OXON HILL RD, OXON HILL, MD 20745-3010
(301) 839-0729
(301) 567-9072
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
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
P06645
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214185000
—
MD
01
—
2149969
PK
—
Enumeration date
06/21/2006
Last updated
07/18/2022
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