NPIMap

Organization Active NPI

United Supermarkets LLC

Doing business as Albertsons Market Pharmacy #0920

  • Community/Retail Pharmacy
  • Taos, NM
National Provider Identifier
1720286156
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH00004389 Issued in NM
Legal business name
UNITED SUPERMARKETS LLC
Doing business as
Albertsons Market Pharmacy #0920
Albertsons Market Pharmacy #2920
Practice address
710 Paseo del Pueblo Sur Ste a
Taos, NM 87571-5998
Phone
(575) 758-1203
Fax
(575) 758-3583
NPI assigned
Jul 6, 2007
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X PH00004389 NM Primary

Addresses

Primary practice location

710 Paseo del Pueblo Sur Ste a
Taos, NM 87571-5998

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other identifiers 2

IdentifierTypeStateIssuer
11032863MedicaidNM
2059016OtherPK

Other names 2

  • ALBERTSONS MARKET PHARMACY #0920 Doing business as
  • ALBERTSONS MARKET PHARMACY #2920 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041014000405 TX Part B Supplier - Centralized Flu Biller 8729983515 This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID
O20171122001514 NM DME Supplier - PharmacyDME Supplier - Grocery Store 0143126524 Practice locations: Taos, NM

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
32D2020483Albertsons Market Pharmacy #2920710 Paseo de Pueblo Sur Ste a, Taos, NM 87571Certificate of waiverFeb 20, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Albertsons Market Pharmacy #2920710 Paseo del Pueblo Sur, Taos, NM 87571-5998(575) 758-1203 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
Tax ID family
United Pharmacy41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Member of 4

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

Locations

710 Paseo del Pueblo Sur
Ste A
Taos, NM 87571
Phone (575) 758-1203

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1720286156",
    "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": "710 PASEO DEL PUEBLO SUR STE A",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715998",
            "telephone_number": "575-758-1203",
            "fax_number": "575-758-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED SUPERMARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00004389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11032863",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2059016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALBERTSONS MARKET PHARMACY #0920",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ALBERTSONS MARKET PHARMACY #2920",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.