Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY #3214
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1000 W 11TH ST, QUANAH, TX 79252-5214
(940) 663-2733
(940) 228-3333
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
21388
TX
333600000X
Pharmacy
21388
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148873601
—
TX
01
—
4585886
NCPDP
TX
05
—
465177
—
TX
Enumeration date
11/03/2005
Last updated
03/09/2026
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