Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY #0221, United Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2522 IOWA PARK RD, WICHITA FALLS, TX 76306
(940) 322-1114
(940) 767-3908
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
21392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149309001
—
TX
01
—
4581496
NCPDP
TX
05
—
465182
—
TX
Enumeration date
02/02/2007
Last updated
03/12/2026
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