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General NPI Number Information
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NPI Number | 1164560256
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Entity Type | Organization
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Legal Business Name | UNITED SUPERMARKETS LLC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 2806 S MAIN ST
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City | PERRYTON
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State | TX
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Zip | 79070-5346
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Country | US
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Telephone | 806-435-2211
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Fax | 806-435-2701
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Provider Business Mailing Address
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Address Line | 7830 ORLANDO AVE
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City | LUBBOCK
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State | TX
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Zip | 79423-1942
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Country | US
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Telephone | 806-791-8113
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Fax | 806-791-7490
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | TIM PURSER
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Credential |
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Telephone | 806-791-7410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 25310
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License Number State | TX
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