BROULIM SUPERMARKETS, LLC

Community/Retail Pharmacy

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 dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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Contact Information

BROULIM SUPERMARKETS, LLC

570 S STATE ST
SHELLEY, ID 83274-1470

Phone: 208-357-0473
Fax: 844-721-6089
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community/Retail Pharmacy	3336C0003X	58	Medical Supply Company with Pharmacist
Clinic Pharmacy	3336C0002X	58	Medical Supply Company with Pharmacist
Pharmacy	333600000X	58	Medical Supply Company with Pharmacist
Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for BROULIM SUPERMARKETS, LLC

NPI # 1396870911

LBN Legal business name BROULIM SUPERMARKETS, LLC

Authorized official MARCUS HURST - (PHARMACY DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/22/2007

Last updated 07/03/2025 - About 11 months ago

Identifiers

ID	Medicaid	1396870911
	Other	1307493	NCPDP
ID	Other	1876RP	BOARD OF PHARMACY

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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