# UNITED SUPERMARKETS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UNITED PHARMACY \#663, United Pharmacy \#0663
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962028902
- **Authorized official:** KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
- **Authorized official phone:** (208) 395-3954

## Contact information

- **Practice address:** 2783 S CEDAR ST, PECOS, TX 79772-6206
- **Practice address phone:** (432) 755-3160
- **Practice address fax:** (432) 755-5006
- **Mailing address:** 250 E PARKCENTER BLVD, BOISE, ID 83706-3940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/24/2020
- **Last updated:** 02/18/2026