United Supermarkets LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

UNITED SUPERMARKETS LLC

Practice address

311 S Avenue D
Burkburnett, TX 76354-3541

Phone

(940) 569-3319

Fax

(940) 569-5359

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Addresses

Other identifiers 3

Other names 1

• UNITED PHARMACY #4515 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Member of 1

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

• Haggen Opco North LLC

  • Community/Retail Pharmacy
  • Grants Pass, OR
  • NPI 1063468064

  Member Of

  NPD member

Locations

Practitioners 2

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

• Jerry Michael Johnson, PHARMACIST

  • Pharmacist
  • Burkburnett, TX
  • NPI 1962057802
  NPD (past)
• Ryan Wells

  • Pharmacist
  • Burkburnett, TX
  • NPI 1639733819
  NPD (past)

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": "1912998378",
    "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": "311 S AVENUE D",
            "city": "BURKBURNETT",
            "state": "TX",
            "postal_code": "763543541",
            "telephone_number": "940-569-3319",
            "fax_number": "940-569-5359"
        }
    ],
    "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": "TX",
            "license": "21389",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "21389",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4576344",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465178",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149313201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNITED PHARMACY #4515",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Therapy Talks Speech & Language Services PLLC
• Ella Morgan Thompson, LPC
• Top Tier Behavior and Wellness, LLC,
• Oscar C Torres, M.D.
• Rosa A Torres, M.D.
• Ashley Nichole Ward, LVN
• Ryan Wells
• Lisa Ann Wick
• Jonathan Wayne Williams, MD
• Christopher Kevin Wyatt, M.D.

• Community/Retail Pharmacy in Burkburnett, TX
• Providers in Burkburnett, TX by specialty
• Community/Retail Pharmacy in Texas

• 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.