NPI age
7 years
Enumerated 2019-04-12
● Active Type 2 · Organization
Broulim Supermarkets, Llc
Broulim Supermarkets, Llc is 1 of 397 pharmacy organizations in Idaho.
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
7 years
↓ 12 yr below median
Practice locations
1
0 secondary on file
Subspecialties
3
In the 70% of peers with subspecialties
NPI lifetime · 2019 → 2026
2019-04Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
3160 E 17th St Ste 164
Ammon, ID 834066784
Mailing address
160 S Clark St
Rigby, ID 834421407
Authorized official
Marcus Hurst, PHARMD
Pharmacy Director
📞 2087459201
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Joseph Brown, PHARMD Pharmacist NPI 1346417003
- Jacee Clark, PHARMD Pharmacist NPI 1043937741
- Jared Lyon, PHARMD., RPH Pharmacist NPI 1912304049
- Kyren Tweedie Student in an Organized Health Care Education/Training Program NPI 1609748854
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 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...
-
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 |
|---|---|---|
| 05 (ID) | 1851854095 | |
| 01 (WY) | NR-51740 | BOARD OF PHARMACY |
| 01 | 1309954 | NCPDP |
| 01 (ID) | 53249RP | BOARD OF PHARMACY |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Broulim's Pharmacy #17 - 17th Street
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 397 Pharmacy providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
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.