Broulims Pharmacy

LBN: Broulim Supermarkets, Llc
Broulims Pharmacy is an health care organization with primary practice located at 150 N State St , Rigby ID 83442-1443. 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) 745-0267, or through Hurst, Marcus C via phone (208) 745-9201.

Contact Information

Primary practice address
150 N State St Rigby ID 83442-1443
Phone: (208) 745-0267
Fax: (208) 745-0208
Website:
Map and Directions
Authorized official contact:
Name: Hurst, Marcus C PHARMD
Phone: (208) 745-9201

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 1090CP Idaho

Profile Details

NPI number 1720132178
LBN Legal business name Broulim Supermarkets, Llc
DBA Doing business as Broulims Pharmacy
Authorized official Hurst, Marcus C PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 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 1720132178 NPPES
Other 1305831 NCPDP PROVIDER IDENTIFICATION NUMBER
Other 1912011 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 1720132178 NCPDP PROVIDER IDENTIFICATION NUMBER

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