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Organization
UNITED SUPERMARKETS LLC
Active
Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY #663, United Pharmacy #0663
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2783 S CEDAR ST, PECOS, TX 79772-6206
(432) 755-3160
(432) 755-5006
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Enumeration date
06/24/2020
Last updated
02/18/2026
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