Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #2853
Organization subpart
No
Provider details
NPI number
Authorized official
SUNNY YOST (ASST MGR, THIRD PARTY IMPLEMENTATIO)
(208) 395-3920
Entity
Organization
Contact information
Practice address
15916 CRAIN HWY, BRANDYWINE, MD 20613-8000
(301) 242-9264
(301) 242-9265
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
P06639
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214176100
—
MD
01
—
2150022
PK
—
Enumeration date
02/03/2009
Last updated
01/08/2016
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