United Supermarkets LLC
Organization Active NPI Community/Retail Pharmacy · Levelland, TX
NPI 1043201593 · NPPES record last updated Apr 27, 2026
Key facts
- NPI
- 1043201593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 21424 (TX)
- Legal business name
- UNITED SUPERMARKETS LLC
- Practice address
- 511 College Ave
Levelland, TX 79336-4805 - Phone
- (806) 894-7315
- Fax
- (806) 894-5996
- NPI assigned
- Nov 3, 2005
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollments Manager
- Phone
- (208) 395-3954
Member of 1
Practitioners 4
-
Roy Taylor Gregory, PHARM D
-
Jason Hallier, PHARM.D.
-
Amber Lockett, PHARM.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2103090 | United Pharmacy #3509 | Certificate of waiver | Oct 5, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| United Pharmacy #3509 |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930078874 | TX | DME Supplier - Pharmacy |
0143126524 | Practice locations: Levelland, TX |
| O20101124000158 | TX | Part B Supplier - Centralized Flu Biller | 0143126524 |
This NPI is an additional NPI on the enrollment Practice locations: Boise, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 21424 | TX | Yes |
Addresses
Primary practice location
511 College Ave
Levelland, TX 79336-4805
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2098672 | Other | PK | |
| 465175 | Medicaid | TX | |
| 148872801 | Medicaid | TX |
Other names
- UNITED PHARMACY #3509
- UNITED PHARMACY #509
Other providers in Levelland, TX
- Robby Don Timberlake
- Lance M Tolbert
- Brigitte Rachel Torres
- Amanda Torrez
- Tricare Medical
- Tommie Vidales
- Wal-Mart Stores Texas LLC
- Wal-Mart Stores Texas, LP
- Harry Talmadge Weaver Jr.
- West Texas Optimal Health
All providers in Levelland, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.