National Provider Identifier Database

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.


Contact Information

BROULIM SUPERMARKETS LLC
89 W 2ND S
SODA SPRINGS, ID83276-1509
Phone: 208-547-3300
Fax: 855-847-9646
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Clinic Pharmacy 3336C0002X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for BROULIM SUPERMARKETS LLC

NPI Number 1508926734
Legal business name
LBN
BROULIM SUPERMARKETS LLC
Authorized official MARCUS HURST - (PHARMACY DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/11/2006
Last updated 07/03/2025 - About 11 months ago
Sole proprietor1 Not specified
Identifiers
  • ID Medicaid: 1508926734
  • Other: 1306162 NCPDP
  • ID Other: 2098RP BOARD OF PHARMACY

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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