Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED COALITION PHARMACY, UNITED COALITION PHARMACY #0200
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1610 5TH ST, LUBBOCK, TX 79401-2622
(806) 763-9999
(806) 791-8168
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
21381
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151257601
—
TX
01
—
2099239
PK
—
05
—
470897
—
TX
Enumeration date
11/03/2005
Last updated
05/13/2026
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