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Organization

UNITED SUPERMARKETS LLC

Active
Other names
United Pharmacy, UNITED PHARMACY #0146, UNITED PHARMACY #4990
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
101 N WASHINGTON ST, SEYMOUR, TX 76380-2556
(940) 889-3622
(940) 889-2766
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
30904
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2159524
PK
05
466360
TX
Enumeration date
07/30/2006
Last updated
05/11/2026
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