Organization
UNITED SUPERMARKETS LLC
Active
Other names
Larson's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM PURSER (DIRECTOR OF PHARMACY)
(806) 791-0220
Entity
Organization
Contact information
Practice address
2802 W WALKER ST, BRECKENRIDGE, TX 76424-4000
(254) 559-4080
(254) 559-4082
Mailing address
7830 ORLANDO AVE, LUBBOCK, TX 79423-1942
(806) 791-0220
(806) 791-7490
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
24031
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159520
PK
—
05
—
466207
—
TX
Enumeration date
08/10/2006
Last updated
02/23/2017
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