Organization
MADISON MEMORIAL HOSPITAL
Active
Parent organization
MADISON MEMORIAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADISON MEMORIAL HOSPITAL
Authorized official
DORSIE SULLENGER RPH (DIRECTOR OF PHARMACY)
(208) 359-6900
Entity
Organization
Contact information
Practice address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 359-6900
Mailing address
6501 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3248
(952) 653-2525
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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