Broulims Pharmacy

LBN: Broulims Supermarkets, Llc
Broulims Pharmacy is an health care organization with primary practice located at 130 S 4Th St , Montpelier ID 83254-1538. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Broulims Supermarkets, Llc can be contacted via phone (208) 847-0806, or through Hurst, Marcus C via phone (208) 745-9201.

Contact Information

Primary practice address
130 S 4Th St Montpelier ID 83254-1538
Phone: (208) 847-0806
Fax: (208) 847-0841
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 2322CP Idaho

Profile Details

NPI number 1750525754
LBN Legal business name Broulims Supermarkets, Llc
DBA Doing business as Broulims Pharmacy
Authorized official Hurst, Marcus C PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2009
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 1750525754 NPPES
Idaho Other 1912011 IMMUNIZATION SUPPLIER NSC
Idaho Other 1308217 IMMUNIZATION SUPPLIER NSC
Idaho MEDICAID 1750525754 IMMUNIZATION SUPPLIER NSC

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