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BROULIM SUPERMARKETS, LLC
NPI 1720132178
Pharmacy - Community/Retail Pharmacy in Rigby, ID

Active since January 23, 2007
150 N STATE ST, RIGBY, ID 83442(208) 745-0267(866) 238-2549 Get Directions Write a Review

NPPES record last updated: July 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 3, 2025, Nov 19, 2024, Jan 29, 2021 and 4 more (7 updates tracked since 2016).

About Broulim Supermarkets, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROULIM SUPERMARKETS, LLC (NPI 1720132178), doing business as Broulims Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Rigby, Idaho and active in the NPI registry since January 2007. The organization lists Marcus C Hurst, Pharmacy Director, as its authorized official.

NPPES Registry Identity

NPI1720132178
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBROULIM SUPERMARKETS, LLC
Location Address150 N STATE STRigby, ID 83442-1443
Mailing Address160 S Clark StRigby, ID 83442-1407 · (208) 745-9201 · Fax (208) 745-7433
Phone(208) 745-0267
Fax(866) 238-2549
Organization SubpartNo
Authorized OfficialMarcus C HurstPharmacy Director · (208) 745-9201
Enumeration DateJanuary 23, 2007
Last NPPES UpdateJuly 3, 20257 updates tracked since enumeration
NPPES CertifiedJuly 3, 2025
✔ NPI 1720132178 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
150 N STATE ST, Rigby, ID 83442
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Other Names 1

Doing Business AsBroulims Pharmacy

Other Identifiers 3

Other1305831Ncpdp Provider Identification Number
Other1912011ID · Medicare Noridian
Medicaid1720132178ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broulim Supermarkets, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIdahoEnrollment IDO20110928000334Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
190 services189 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
166 services165 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
11 services11 patients

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATHANIEL BROWN
Pharmacist
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-7771
MARC ANDERSON
Pharmacist
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-0267
MR. JASON EARL WATTS PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-0267
DR. CLINTON J THACKERAY
Pharmacist
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-0267
OSCAR M WALDO PHARMD
Pharmacist
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-0267
GARRET PORTELA
Pharmacist
150 N STATE ST
RIGBY, ID 83442
Jefferson County (208) 745-0267

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broulim Supermarkets, LLC's NPI number?

The NPI number for Broulim Supermarkets, LLC is 1720132178. It was assigned to this organization in the NPPES registry on January 23, 2007. The provider is doing business as Broulims Pharmacy.

Where is Broulim Supermarkets, LLC located?

Broulim Supermarkets, LLC is located at 150 N State St, Rigby, ID 83442. The listed phone number is (208) 745-0267.

What is Broulim Supermarkets, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Broulim Supermarkets, LLC enrolled in Medicare?

Yes. Broulim Supermarkets, LLC is registered in the Medicare PECOS enrollment system.

When is Broulim Supermarkets, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Mass Immunization (Roster Biller Only)) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Broulim Supermarkets, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 46 other insurers list Broulim Supermarkets, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Broulim Supermarkets, LLC was last updated on July 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.