Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY #3532, UNITED PHARMACY #532
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
201 N 23RD ST, CANYON, TX 79015-2516
(806) 655-5757
(806) 655-2909
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
22820
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099540
PK
—
05
—
469932
—
TX
Enumeration date
12/30/2005
Last updated
04/06/2026
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