NPI age
19 years
Enumerated 2007-01-23
● Active Type 2 · Organization
Broulim Supermarkets, Llc
Broulim Supermarkets, Llc is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 2 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
2
In the 70% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
150 N State St
Rigby, ID 834421443
Mailing address
160 S Clark St
Rigby, ID 834421407
Authorized official
Marcus C Hurst, PHARMD
Pharmacy Director
📞 2087459201
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Marc Anderson Pharmacist NPI 1316314842
- Nathaniel Brown Pharmacist NPI 1083161186
- Garret Portela Pharmacist NPI 1912319799
- Clinton Thackeray Pharmacist NPI 1780937151
- Oscar Waldo, PHARMD Pharmacist NPI 1891357802
- Jason Watts, PHARMD Pharmacist NPI 1528242807
Specialties
-
Pharmacy PrimaryA 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...
-
Clinic/CenterDefinition to come...
-
PharmacyA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1305831 | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 01 (ID) | 1912011 | MEDICARE NORIDIAN |
| 05 (ID) | 1720132178 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Broulims Pharmacy
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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- 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.