Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIM PURSER (STAFF)
(806) 791-0220
Entity
Organization
Contact information
Practice address
4209 BUFFALO GAP RD, ABILENE, TX 79606-2706
(325) 690-1008
(325) 690-6573
Mailing address
7830 ORLANDO AVE, LUBBOCK, TX 79423-1942
(806) 791-0220
(806) 791-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4522517
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
465196
—
TX
Enumeration date
12/30/2005
Last updated
11/22/2010
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