Organization
UNITED SUPERMARKETS LLC
Active
Other names
AMIGOS PHARMACY #1308, AMIGOS PHARMACY #508
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
2403 N COLUMBIA ST, PLAINVIEW, TX 79072-3119
(806) 293-3820
(806) 293-7327
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
21386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148865201
—
TX
01
—
2093437
PK
—
05
—
465174
—
TX
Enumeration date
11/03/2005
Last updated
04/06/2026
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