Organization
UNITED SUPERMARKETS LLC
Active
Other names
MARKET STREET PHARMACY #4566, Market Street Pharmacy #566
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1929 PRESTON RD, PLANO, TX 75093-5102
(972) 713-5515
(972) 713-5516
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
26345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119117
PK
—
05
—
466583
—
TX
Enumeration date
02/24/2009
Last updated
05/12/2026
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