NPIMap

Organization Active NPI

United Supermarkets LLC

Doing business as United Pharmacy #0663

  • Durable Medical Equipment & Medical Supplies
  • Pecos, TX
National Provider Identifier
1962028902
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UNITED SUPERMARKETS LLC
Doing business as
United Pharmacy #0663
Practice address
2783 S Cedar St
Pecos, TX 79772-6206
Phone
(432) 755-3160
Fax
(432) 755-5006
NPI assigned
Jun 24, 2020
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 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 2

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

Addresses

Primary practice location

2783 S Cedar St
Pecos, TX 79772-6206

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Other names 1

  • United Pharmacy #0663 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201102002460 TX DME Supplier - PharmacyDME Supplier - Grocery Store 0143126524 Practice locations: Pecos, TX

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
45D2228725United Pharmacy # 06632783 S Cedar St, Pecos, TX 79772Certificate of waiverJun 29, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
United Pharmacy #06632783 S Cedar St, Pecos, TX 79772-6206(432) 755-3160 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 Supermarkets LLC41 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 1

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

Locations

2783 S Cedar St
Pecos, TX 79772
Phone (432) 755-3160

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1962028902",
    "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": "2783 S CEDAR ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797726206",
            "telephone_number": "432-755-3160",
            "fax_number": "432-755-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED SUPERMARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "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": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Pharmacy #0663",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pecos, TX

Sources for this page

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