Organization
UNITED SUPERMARKETS LLC
Active
Other names
MARKET STREET PHARMACY #0685, MARKET STREET PHARMACY #685
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
4268 LEGACY DR, FRISCO, TX 75034
(214) 705-0364
(214) 705-0363
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
Primary
31775
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2174783
PK
—
05
—
471220
—
TX
Enumeration date
10/12/2017
Last updated
05/11/2026
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