| NPI | 1851854095 |
|---|---|
| Doing Business As | BROULIM'S PHARMACY #17 - 17TH STREET |
| Entity Type | Organization |
| Authorized Contact | MARCUS HURST Pharmacy Director 208-745-9201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 333600000X Pharmacy | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-07-03 |