Organization
UNITED SUPERMARKETS LLC
Active
Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY #505, UNITED PHARMACY #0605
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
401 SLIDE RD, LUBBOCK, TX 79416-4315
(806) 796-1895
(806) 792-3013
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
21384
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148857901
—
TX
01
—
2098010
PK
—
05
—
465172
—
TX
Enumeration date
11/03/2005
Last updated
05/11/2026
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