| Broulims Pharmacy | |
|
150 N State St Rigby ID 83442-1443 | |
| (208) 745-0267 | |
| (866) 238-2549 |
| Full Name | Broulims Pharmacy |
|---|---|
| Speciality | Pharmacy |
| Location | 150 N State St, Rigby, Idaho |
| Authorized Official Name and Position | Marcus C Hurst (PHARMACY DIRECTOR) |
| Authorized Official Contact | 2087459201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broulims Pharmacy 160 S Clark St Rigby ID 83442-1407 Ph: (208) 745-9201 | Broulims Pharmacy 150 N State St Rigby ID 83442-1443 Ph: (208) 745-0267 |
| NPI Number | 1720132178 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 07/03/2025 |
| Certification Date | 07/03/2025 |
| Medicare PECOS PAC ID | 5890966691 |
|---|---|
| Medicare Enrollment ID | O20110928000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720132178 | NPI | - | NPPES |
| 1305831 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 1912011 | Other | ID | MEDICARE NORIDIAN |
| 1720132178 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | () | Secondary |
| 3336C0003X | Pharmacy - Community/retail Pharmacy | () | Primary |
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