NPI age
13 years
Enumerated 2012-11-07
● Active Type 2 · Organization
Subpart
Madison Memorial Hospital
Madison Memorial Hospital is 1 of 14 non-pharmacy dispensing site organizations in Idaho.
Primary specialty
Non-Pharmacy Dispensing Site
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Sullenger
Director Of Pharmacy
Last NPPES update
2012-11-07
Source: monthly bulk 2026-05
How this organization compares
Across 14 active non-pharmacy dispensing site providers in Idaho.
NPI age
13 years
≈ at median (13 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-11Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
450 E Main St
Rexburg, ID 834402048
Mailing address
6501 City West Pkwy
Eden Prairie, MN 553443248
Authorized official
Dorsie Sullenger, RPH
Director Of Pharmacy
📞 2083596900
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Lorinda Allred Psychiatry & Neurology NPI 1588542161
- David Anderson, RPH Pharmacist NPI 1376192674
- Michael Anderson, D.O. Emergency Medicine NPI 1194019406
- Debra Brand, MD Emergency Medicine NPI 1750472379
- Michael Brunson, PHARMD Pharmacist NPI 1356189146
- Bryce Campbell Nurse Practitioner NPI 1023417037
- Jack Clark, M.D. Internal Medicine NPI 1902992837
- Marci Crook, LMSW Social Worker NPI 1942916721
- Angela Ellis, LMSW Social Worker NPI 1548976202
- Cindi Farnworth, CRNA Nurse Anesthetist, Certified Registered NPI 1467483545
- Todd Gehmlich, CRNA Nurse Anesthetist, Certified Registered NPI 1063443059
- Kyle Gould Social Worker NPI 1982554242
- Jeffrey Grover, CRNA Nurse Anesthetist, Certified Registered NPI 1396859591
- Nathan Hancock, MD Emergency Medicine NPI 1326209537
- David Hansen, M.D. Radiology NPI 1538277629
- Troy Hanson, NP Nurse Practitioner NPI 1215471065
- Gina Harris, MPT Physical Therapist NPI 1598930166
- William Houlihan, CRNA Nurse Anesthetist, Certified Registered NPI 1477738599
- Barton Hunt, CRNA Nurse Anesthetist, Certified Registered NPI 1629254792
- Michael Karren, CRNA Nurse Anesthetist, Certified Registered NPI 1730419730
Specialties
-
Non-Pharmacy Dispensing Site PrimaryA site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
Subpart of Madison Memorial Hospital.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.