| Broulim Supermarkets, LLC | |
|
160 S Clark St Rigby ID 83442-1407 | |
| (208) 745-9201 | |
| (208) 745-3431 |
| Full Name | Broulim Supermarkets, LLC |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 160 S Clark St, Rigby, Idaho |
| Authorized Official Name and Position | Marcus C Hurst (PHARMACY DIRECTOR) |
| Authorized Official Contact | 2087459201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broulim Supermarkets, LLC 160 S Clark St Rigby ID 83442-1407 Ph: (208) 745-9201 | Broulim Supermarkets, LLC 160 S Clark St Rigby ID 83442-1407 Ph: (208) 745-9201 |
| NPI Number | 1366275638 |
|---|---|
| Provider Enumeration Date | 08/22/2024 |
| Last Update Date | 02/19/2025 |
| Certification Date | 02/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366275638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QH0100X | Clinic/center - Health Service | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
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