NPIMap

Organization Active NPI

Nai Saturn Eastern LLC

Doing business as Safeway Pharmacy #2781

  • Community/Retail Pharmacy
  • Silver Spring, MD
National Provider Identifier
1083049688
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P06635 Issued in MD
Legal business name
NAI SATURN EASTERN LLC
Doing business as
Safeway Pharmacy #2781
Practice address
11201 Georgia Ave
Silver Spring, MD 20902-4617
Phone
(301) 933-4684
Fax
(301) 933-8953
NPI assigned
Sep 13, 2013
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Tiffany Eliopulos
Title
Assistant Manager, Enrollments
Phone
(208) 395-3906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X P06635 MD Primary

Addresses

Primary practice location

11201 Georgia Ave
Silver Spring, MD 20902-4617

Mailing address

250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
621015500MedicaidMD
2150018OtherPK

Other names 1

  • Safeway Pharmacy #2781 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
O20150423002062 MD DME Supplier - PharmacyDME Supplier - Grocery Store 4284952185 Practice locations: Silver Spring, 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 23

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

View all 23

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": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1083049688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "address_2": "MAILSTOP SEC2-B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209024617",
            "telephone_number": "301-933-4684",
            "fax_number": "301-933-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAI SATURN EASTERN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "ELIOPULOS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
        "authorized_official_telephone_number": "208-395-3906"
    },
    "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": "P06635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621015500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safeway Pharmacy #2781",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Safeway Pharmacy #2781",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.