Organization
BROULIM SUPERMARKETS, LLC
Active
Other names
Broulim's Pharmacy #6 - Rexburg
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS HURST PHARMD (PHARMACY DIRECTOR)
(208) 745-9201
Entity
Organization
Contact information
Practice address
124 W MAIN ST, REXBURG, ID 83440-1827
(208) 356-5416
(866) 238-5784
Mailing address
160 S CLARK ST, RIGBY, ID 83442-1407
(208) 356-5416
(208) 356-5653
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003969346
—
ID
01
—
1280RP
BOARD OF PHARMACY
ID
Enumeration date
01/19/2007
Last updated
07/03/2025
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