Organization Active NPI

United Supermarkets LLC

Doing business as United Pharmacy

  • Community/Retail Pharmacy
  • Abilene, TX
National Provider Identifier
1083794309
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
30902 Issued in TX
Legal business name
UNITED SUPERMARKETS LLC
Doing business as
United Pharmacy
Practice address
2160 Pine St
Abilene, TX 79601-2436
Phone
(325) 673-4737
Fax
(325) 673-4739
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tim Purser
Title
Director of Pharmacy
Phone
(806) 791-0220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 30902 TX Primary

Addresses

Primary practice location

2160 Pine St
Abilene, TX 79601-2436

Mailing address

7830 Orlando Ave
Lubbock, TX 79423-1942
Phone (806) 791-0220

Other identifiers 2

IdentifierTypeStateIssuer
144078MedicaidTX
2159532OtherPK

Other names 1

  • United Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101124000158 TX Part B Supplier - Centralized Flu Biller 0143126524 This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2123844United Pharmacy #5742160 Pine St, Abilene, TX 79601Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1083794309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 ORLANDO AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231942",
            "telephone_number": "806-791-0220",
            "fax_number": "806-791-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012436",
            "telephone_number": "325-673-4737",
            "fax_number": "325-673-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED SUPERMARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "PURSER",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "806-791-0220"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "30902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144078",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159532",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.