Organization
UNITED SUPERMARKETS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM PURSER RPH (DIRECTOR PHARMACY SERVICES)
(806) 791-0220
Entity
Organization
Contact information
Practice address
4590 KELL BLVD, WICHITA FALLS, TX 76309-4744
(940) 692-3443
(940) 696-5178
Mailing address
7830 ORLANDO AVE, LUBBOCK, TX 79423-1942
(806) 791-0220
(806) 791-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
21391
TX
333600000X
Pharmacy
Primary
21391
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4576356
NCPDP
TX
05
—
465180
—
TX
Enumeration date
11/03/2005
Last updated
12/28/2007
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