Organization
NAI SATURN EASTERN LLC
Active
Other names
Safeway Pharmacy #4270
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
1601 MARYLAND AVE NE, WASHINGTON, DC 20002-7606
(202) 398-6900
(202) 396-0994
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
RX0000081
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033585300
—
DC
01
—
2149947
PK
—
Enumeration date
06/21/2006
Last updated
03/01/2019
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