NPIMap

Organization Active NPI

Nai Saturn Eastern LLC

Doing business as Safeway Pharmacy #1758

  • Community/Retail Pharmacy
  • Perry Hall, MD
National Provider Identifier
1023047040
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P06620 Issued in MD
Legal business name
NAI SATURN EASTERN LLC
Doing business as
Safeway Pharmacy #1758
Practice address
9645 Belair Rd
Perry Hall, MD 21128
Phone
(410) 256-6423
Fax
(410) 256-3765
NPI assigned
Jul 2, 2006
Last updated
May 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathy Giannakopoulos
Title
Enrollments Manager
Phone
(208) 395-3954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P06620 MD Primary

Addresses

Primary practice location

9645 Belair Rd
Perry Hall, MD 21128

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other names 1

  • Safeway Pharmacy #1758 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040819001277 TX Part B Supplier - Centralized Flu Biller 8628980299 This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID
O20150408002231 MD DME Supplier - PharmacyDME Supplier - Grocery Store 4284952185 Practice locations: Perry Hall, MD

National Provider Directory

National Provider Directory
Tax ID family
Nai Saturn Eastern LLC156 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1023047040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 BELAIR RD",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "21128",
            "telephone_number": "410-256-6423",
            "fax_number": "410-256-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAI SATURN EASTERN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P06620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safeway Pharmacy #1758",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perry Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.