Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY, UNITED PHARMACY #0539
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1414 W WILSON ST, BORGER, TX 79007-4420
(806) 273-6427
(806) 274-9557
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
21413
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4586345
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
465194
—
TX
Enumeration date
12/30/2005
Last updated
03/18/2026
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