Organization
UNITED SUPERMARKETS LLC
Active
Other names
ALBERTSONS MARKET PHARMACY #0904, ALBERTSONS MARKET PHARMACY #1904
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4950 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1306
(505) 883-8703
(505) 830-0411
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00004385
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057081
PK
—
05
—
64709
—
NM
Enumeration date
06/04/2006
Last updated
05/11/2026
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