NPI | 1225478894 |
---|---|
Doing Business As | BROULIM'S PHARMACY #4 - THAYNE |
Entity Type | Organization |
Authorized Contact | MARCUS C HURST Pharmacy Director 208-745-9201 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2013-06-27 |
Last Update Date | 2025-07-03 |