Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #2848
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
5000 BRADLEY BLVD, BETHESDA, MD 20815-6559
(301) 654-4769
(301) 941-8067
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
P06638
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214175200
—
MD
01
—
2150016
PK
—
Enumeration date
08/22/2011
Last updated
03/01/2019
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