Organization
UNITED SUPERMARKETS LLC
Active
Other names
ALBERTSONS MARKET PHARMACY #0920, ALBERTSONS MARKET PHARMACY #2920
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
710 PASEO DEL PUEBLO SUR STE A, TAOS, NM 87571-5998
(575) 758-1203
(575) 758-3583
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00004389
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11032863
—
NM
01
—
2059016
PK
—
Enumeration date
07/06/2007
Last updated
05/11/2026
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