OrganizationActive
Madison Memorial Hospital
NPI 1821342247 · Non-Pharmacy Dispensing Site · Rexburg, ID
Provider details
- NPI number
- 1821342247
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Madison Memorial Hospital
- Organization subpart
- Yes
- Authorized official
- Dorsie Sullenger, Director of Pharmacy(208) 359-6900
Specialties & taxonomies
Suppliers
Practice location
450 E Main St
Rexburg, ID 83440-2048
Phone: (208) 359-6900
Approximate (ZIP-level) locationGet directions
Mailing address
6501 City West Pkwy
Eden Prairie, MN 55344-3248
Registry dates
- Enumerated
- 2012-11-07
- Last updated
- 2012-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.