| Broulim Supermarkets, Llc | |
|
2730 E Sunnyside Rd Ammon ID 83406-7547 | |
| (208) 522-3257 | |
| (208) 522-3227 |
| Full Name | Broulim Supermarkets, Llc |
|---|---|
| Speciality | Pharmacy - Community/retail Pharmacy |
| Location | 2730 E Sunnyside Rd, Ammon, Idaho |
| Authorized Official Name and Position | Marcus C Hurst (PHARMACY SUPERVISOR) |
| Authorized Official Contact | 2087459201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broulim Supermarkets, Llc 182 N State St Rigby ID 83442-1444 Ph: (208) 745-9201 | Broulim Supermarkets, Llc 2730 E Sunnyside Rd Ammon ID 83406-7547 Ph: (208) 522-3257 |
| NPI Number | 1336517861 |
|---|---|
| Provider Enumeration Date | 09/15/2015 |
| Last Update Date | 11/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336517861 | NPI | - | NPPES |
| 1336517861 | Medicaid | ID | |
| 1309310 | Other | NCPDP | |
| 1912011 | Other | ID | MEDICARE NORIDIAN |
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