Organization · Type 2 NPI

United Supermarkets LLC

Community/Retail Pharmacy · Mansfield, TX

NPI number 1578074985 Active

Practice location

3145 E Broad St
Mansfield, TX 76063-5602

Call (817) 453-6015 Map

Fax (817) 453-6016

Mailing address

250 E Parkcenter Blvd
Boise, ID 83706-3940

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	31877 (TX)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

5 other providers at this address

Other community/retail pharmacy providers in Mansfield

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NPI record

NPI: 1578074985
Entity type: Organization (Type 2)
Issued: Oct 12, 2017
Last updated: May 11, 2026
Status: Active

Other names

<unavail>
Market Street Pharmacy #0696 · doing business as
Market Street Pharmacy #696 · doing business as

Authorized official

Kathy Giannakopoulos
Enrollments Manager
(208) 395-3954

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1578074985

United Supermarkets LLC's National Provider Identifier is 1578074985, issued on Oct 12, 2017. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Mansfield, TX. The record was last updated on May 11, 2026.