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Organization

UNITED SUPERMARKETS LLC

Active
Other names
MARKET STREET PHARMACY #1326, MARKET STREET PHARMACY #526
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization

Contact information

Practice address
2530 S GEORGIA ST, AMARILLO, TX 79109-1927
(806) 468-9911
(806) 468-6071
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
21395
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149307401
TX
01
2092682
PK
05
465185
TX
Enumeration date
12/30/2005
Last updated
03/18/2026
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