1. Home
  2. Directory
  3. Texas
  4. Vernon
  5. Pharmacy
  6. NPI Profile
  7. NPI Record 1750372207

UNITED SUPERMARKETS, L.L.C.
Complete NPI Record 1750372207
Pharmacy in Vernon, TX

NPI Status: Active since November 03, 2005

Contact Information

3000 WILBARGER ST
VERNON, TX
ZIP 76384
Phone: (940) 552-2600
Fax: (940) 522-5033

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number 1
  27. Provider License Number State Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Healthcare Provider Taxonomy Code 2
  30. Provider License Number 2
  31. Provider License Number State Code 2
  32. Healthcare Provider Primary Taxonomy Switch 2
  33. Other Provider Identifier 1
  34. Other Provider Identifier Type Code 1
  35. Other Provider Identifier State 1
  36. Other Provider Identifier 2
  37. Other Provider Identifier Type Code 2
  38. Other Provider Identifier State 2
  39. Other Provider Identifier Issuer 2
  40. Other Provider Identifier 3
  41. Other Provider Identifier Type Code 3
  42. Other Provider Identifier State 3
  43. Is Organization Subpart
  44. Authorized Official Credential Text

Complete NPI Dataset

This page represents the complete record for NPI 1750372207. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750372207
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Entity Type Code: 2
The city name in the location address of the provider being identified.
Employer Identification Number EIN: UNAVAIL
The State code in the location of the provider being identified.
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Mailing Address: 7830 ORLANDO AVE
The country code in the location address of the provider being identified.
Provider Business Mailing Address City Name: LUBBOCK
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address State Name: TX
The fax number associated with the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 794231942
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Country Code If outside U S : US
The date that a record was last updated or changed.
Provider Business Mailing Address Telephone Number: 8067910220
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider Business Mailing Address Fax Number: 8067917490
The first name of the authorized official.
Provider First Line Business Practice Location Address: 3000 WILBARGER ST
The title or position of the authorized official.
Provider Business Practice Location Address City Name: VERNON
The 10-position telephone number of the authorized official.
Provider Business Practice Location Address State Name: TX
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Postal Code: 763844574
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address Country Code If outside U S : US
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Practice Location Address Telephone Number: 9405522600
Provider Business Practice Location Address Fax Number: 9405225033
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider Enumeration Date: 11/3/2005
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Last Update Date: 7/8/2010
The date that a record was last updated or changed.
Authorized Official Last Name: PURSER
Authorized Official First Name: TIM
The first name of the authorized official.
Authorized Official Title or Position: PHARMACY BUSINESS DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 8067910220
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 332B00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 21387
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: TX
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 333600000X
Provider License Number 2: 21387
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: TX
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: Y
Other Provider Identifier 1: 148853801
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: TX
Other Provider Identifier 2: 4598770
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: TX
Other Provider Identifier Issuer 2: NCPDP
Other Provider Identifier 3: 465176
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: TX
Is Organization Subpart: N
Authorized Official Credential Text: RPH