P Praxis·MD
● Active Type 2 · Organization

Broulim Supermarkets, Llc

Pharmacy·Shelley, ID· NPI 1396870911 · Enumerated 2007 · 19 years on NPI
Broulim Supermarkets, Llc is 1 of 397 pharmacy organizations in Idaho.
NPI age
19 years
Enumerated 2007-02-22
Primary specialty
Pharmacy
Plus 3 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hurst
Pharmacy Director
Last NPPES update
2025-07-03
Source: monthly bulk 2026-05

How this organization compares

Across 397 active pharmacy providers in Idaho.

NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
3
In the 70% of peers with subspecialties

NPI lifetime · 2007 → 2026

2007-02Enumerated in NPPES
2007 2026

Where they practice

Primary practice location
570 S State St
Shelley, ID 832741470
📞 2083570473fax 8447216089
Mailing address
160 S Clark St
Rigby, ID 834421407
📞 2087459201fax 2087457433

Authorized official

Marcus C Hurst, PHARMD
Pharmacy Director
📞 2087459201

Individual providers at this organization

4 individual providers on file at this primary practice address.

Specialties

  • Pharmacy Primary
    A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the...
    taxonomy 3336C0003X
  • Clinic/Center
    Definition to come...
    taxonomy 261QP2300X
  • Pharmacy
    A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
    taxonomy 333600000X
  • Pharmacy
    A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
    taxonomy 3336C0002X

Identifiers

TypeValueNotes
01 (ID) 1876RP BOARD OF PHARMACY
05 (ID) 1396870911
01 1307493 NCPDP

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Broulim's Pharmacy #9 - Shelley
    Type code 3 recorded 2025-07-03

Practice context

Multi-provider organization. 4 individual providers on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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