Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY, UNITED PHARMACY #3527
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1501 E AMARILLO BLVD, AMARILLO, TX 79107-5554
(806) 373-7057
(806) 373-2465
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
21396
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4578906
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
465186
—
TX
Enumeration date
12/30/2005
Last updated
04/06/2026
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