Organization
UNITED SUPERMARKETS LLC
Active
Other names
UNITED PHARMACY, UNITED PHARMACY #0034
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
1601 TENNESSEE AVE, DALHART, TX 79022-5110
(806) 249-4772
(806) 249-9717
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
21410
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4598869
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
465191
—
TX
Enumeration date
12/30/2005
Last updated
04/06/2026
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