Organization Name: | BROULIM SUPERMARKETS LLC |
NPI Number: | 1003969346 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARCUS HURST (PHARMACY SUPERVISOR) |
Mailing Address: | 124 W Main St Rexburg |
State: | ID US |
Postal Code: | 834401827 |
Phone Number: | 2083565416 |
Fax Number: | 2083565653 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |