Organization
UNITED SUPERMARKETS LLC
Active
Other names
MARKET STREET PHARMACY #0263, MARKET STREET PHARMACY #563
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
985 W BETHANY DR, ALLEN, TX 75013-3740
(972) 908-3840
(972) 908-3841
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
25816
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2101100
PK
—
05
—
466468
—
TX
Enumeration date
01/16/2008
Last updated
05/11/2026
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