United Supermarkets LLC
Organization Active NPI Community/Retail Pharmacy · Perryton, TX
NPI 1164560256 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1164560256
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 25310 (TX)
- Legal business name
- UNITED SUPERMARKETS LLC
- Practice address
- 2806 S Main St
Perryton, TX 79070-5346 - Phone
- (806) 435-7160
- Fax
- (806) 435-7231
- NPI assigned
- Feb 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Kathy Giannakopoulos
- Title
- Enrollments Manager
- Phone
- (208) 395-3954
Member of 1
Practitioners 2
-
Casey Don McGarraugh, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| 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 |
| O20141008001623 | TX | DME Supplier - Pharmacy |
0143126524 | Practice locations: Perryton, TX |
National Provider Directory
Locations
2806 S Main St
Perryton, TX 79070
Phone (806) 435-7160
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 25310 | TX | Yes |
Addresses
Primary practice location
2806 S Main St
Perryton, TX 79070-5346
Mailing address
250 E Parkcenter Blvd
Boise, ID 83706-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 466333 | Medicaid | TX | |
| 130064 | Medicaid | TX | |
| 2098775 | Other | PK |
Other names
- UNITED PHARMACY #1325
- UNITED PHARMACY #525
Other providers in Perryton, TX
- Stratford Hospital District D/B/a Senior Valley Nursing Home
- Tamren Jade Terhune
- Dana Michele Tow
- Jennifer Lynn Tracy
- Tri-State Area Behavioral Health LLC
- United Supermarkets, LTD.
- United Supermarkets, LTD.
- United Supermarkets, LTD.
- Whitehead Chiropractic Health Center, LLC
- Jarel Whitehead
All providers in Perryton, 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 Mar 18, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.