Active NPI
United Supermarkets LLC
Doing business as United Pharmacy
- Community/Retail Pharmacy
- Abilene, TX
National Provider Identifier
1083794309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 30902
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144078 | Medicaid | TX | |
| 2159532 | Other | PK |
Other names 1
- United Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2123844 | United Pharmacy #574 | Certificate of waiver | Jan 3, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Haggen Pharmacy #2102
- Community/Retail Pharmacy
- Grants Pass, OR
- NPI 1063468064
Member Of
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Abilene, TX
- NPI 1427604008
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
- Odira Ughanze, LPC
- United House Calls of Texas, Inc (United House Calls of Texas)
- United States Air Force
- United Supermarkets LLC (Market Street Pharmacy)
- United Supermarkets LLC (United Pharmacy #548)
- United Supermarkets LLC (United Pharmacy)
- United Supermarkets LLC (United Pharmacy #3547)
- Craig D Urban, M.D.
- Jonathan Patrick Urbanczyk, D.O.
- Nicole Leann Urbanczyk, PT
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.