Organization Active NPI

United Supermarkets LLC

  • Community/Retail Pharmacy
  • Amarillo, TX
National Provider Identifier
1124019542
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
22002 Issued in TX
Legal business name
UNITED SUPERMARKETS LLC
Practice address
5601 W Amarillo Blvd
Amarillo, TX 79106-4141
Phone
(806) 352-6650
Fax
(806) 352-7833
NPI assigned
Nov 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Kathy Giannakopoulos
Title
Enrollments Manager
Phone
(208) 395-3954

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 22002 TX Primary

Addresses

Primary practice location

5601 W Amarillo Blvd
Amarillo, TX 79106-4141

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 4

IdentifierTypeStateIssuer
2097956OtherPK
162856202MedicaidTX
162856201MedicaidTX
469455MedicaidTX

Other names 2

  • UNITED PHARMACY #0823 Doing business as
  • UNITED PHARMACY #523 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930092844 TX DME Supplier - PharmacyDME Supplier - Grocery Store 0143126524 Practice locations: Amarillo, TX
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
45D1003140United Supermarkets Pharmacy # 08235601 W Amarillo Blvd, Amarillo, TX 79106Certificate of waiverAug 22, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
United Pharmacy #08235601 W Amarillo Blvd, Amarillo, TX 79106-4141(806) 352-6650 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 assignmentParticipating since Apr 11, 2000

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 5

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": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1124019542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 W AMARILLO BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064141",
            "telephone_number": "806-352-6650",
            "fax_number": "806-352-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED SUPERMARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "GIANNAKOPOULOS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ENROLLMENTS MANAGER",
        "authorized_official_telephone_number": "208-395-3954"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "22002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097956",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162856202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162856201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469455",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNITED PHARMACY #0823",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNITED PHARMACY #523",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.