Broulims Phrmacy

LBN: Broulim Supermarkets, Llc
Broulims Phrmacy is an health care organization with primary practice located at 240 S Main St , Driggs ID 83422-5401. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Broulim Supermarkets, Llc can be contacted via phone (208) 354-0057, or through Hurst, Marcus via phone (208) 745-9201.

Contact Information

Primary practice address
240 S Main St Driggs ID 83422-5401
Phone: (208) 354-0057
Fax: (208) 354-9916
Website:
Map and Directions
Authorized official contact:
Name: Hurst, Marcus PHARMD
Phone: (208) 745-9201

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 1954CP Idaho

Profile Details

NPI number 1427101674
LBN Legal business name Broulim Supermarkets, Llc
DBA Doing business as Broulims Phrmacy
Authorized official Hurst, Marcus PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2007
Last updated Jan 29th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427101674 NPPES
Other 1307568 NCPDP
MEDICAID 1427101674 NCPDP
Other 1912011 NCPDP

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