Organization
UNITED SUPERMARKETS LLC
Active
Other names
MARKET STREET PHARMACY #921, MARKET STREET PHARMACY #0921
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2200 UNSER BLVD SE, RIO RANCHO, NM 87124-5134
(575) 727-8989
(575) 727-8999
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
—
—
Other
Enumeration date
10/17/2024
Last updated
05/11/2026
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