MEDICARE: UNITED SUPERMARKETS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	21410	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4598869	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902883804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED SUPERMARKETS LLC

Provider Business Mailing Address
First Line	:	7830 ORLANDO AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-1942
Country	:	US
Telephone Number	:	806-791-0220
Fax Number	:	806-791-7490

Provider Business Practice Location Address
First Line	:	1601 TENNESSEE AVE
Second Line	:
City	:	DALHART
State	:	TX
Zip	:	79022-5110
Country	:	US
Telephone Number	:	806-249-4772
Fax Number	:	806-249-9717

Authorized Official
Title or Position	:	STAFF
Name	:	TIM PURSER
Credential	:
Telephone Number	:	806-791-0220

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	11/22/2010

Similar Medicare Providers

1639724842 — GARY W JOHNSON RPH
Practice Location Address:

1601 TENNESSEE AVE
DALHART, TX
79022-5110

Practice Phone: 806-249-4772
Practice Fax: 806-249-9717

1922613678 — ASHLEY ALBRECHT PHARMD
Practice Location Address:

1601 TENNESSEE AVE
DALHART, TX
79022-5110

Practice Phone: 806-249-4772
Practice Fax:

1639176456 — DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Practice Location Address:

1411 DENVER AVE
DALHART, TX
79022

Practice Phone: 806-244-4571
Practice Fax: 806-244-5013

1396746152 — MR. TIMOTHY ALLEN JONES CRNA, DNS
Practice Location Address:

1809 ARROYA RD
DALHART, TX
79022-4805

Practice Phone: 806-333-0629
Practice Fax:

1649265091 — G & J JOHNSON ENTERPRISES INC
Practice Location Address:

704 MAPLE AVE
DALHART, TX
79022-3814

Practice Phone: 806-244-8616
Practice Fax: 806-244-8190

1942297684 — MRS. AMANDA DALE COX FNP-C
Practice Location Address:

1021 E 10TH ST
DALHART, TX
79022-4005

Practice Phone: 806-244-0003
Practice Fax: 806-288-6041

Directions to “UNITED SUPERMARKETS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.