BROULIM SUPERMARKETS, LLC
NPI 1851854095
Pharmacy - Community/Retail Pharmacy in Ammon, ID

Active since April 12, 2019
3160 E 17TH ST STE 164, AMMON, ID 83406(208) 529-1795(833) 887-9908 Get Directions Write a Review

NPPES record last updated: July 3, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 3, 2025, Nov 19, 2024, Jan 29, 2021 and 2 more (5 updates tracked since 2019).

About Broulim Supermarkets, Llc NPPES

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

BROULIM SUPERMARKETS, LLC (NPI 1851854095), doing business as Broulim's Pharmacy #17 - 17th Street, is a healthcare organization registered as a community/retail pharmacy in Ammon, Idaho and active in the NPI registry since April 2019. The organization lists Marcus Hurst, Pharmacy Director, as its authorized official.

NPPES Registry Identity

NPI1851854095
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBROULIM SUPERMARKETS, LLC
Location Address3160 E 17TH ST STE 164Ammon, ID 83406-6784
Mailing Address160 S Clark StRigby, ID 83442-1407 · (208) 745-9201 · Fax (208) 745-3431
Fax(833) 887-9908
Organization SubpartNo
Authorized OfficialMarcus HurstPharmacy Director · (208) 745-9201
Enumeration DateApril 12, 2019
Last NPPES UpdateJuly 3, 20255 updates tracked since enumeration
NPPES CertifiedJuly 3, 2025
NPI 1851854095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

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 ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
3160 E 17TH ST STE 164, Ammon, ID 83406

Other Names 1

Doing Business AsBroulim's Pharmacy #17 - 17th Street

Other Identifiers 4

Medicaid1851854095ID
OtherNR-51740WY · Board Of Pharmacy
Other1309954Ncpdp
Other53249RPID · Board Of Pharmacy

Accepted Insurance

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 79 times for 76 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 49 times for 49 patients

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Pharmacy (Community/Retail Pharmacy)
3160 E 17TH ST STE 164
AMMON, ID 83406
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Student in an Organized Health Care Education/Training Program
3160 E 17TH ST STE 164
AMMON, ID 83406

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1851854095, enumerated as an "organization" on April 12, 2019.

The provider is located at 3160 E 17TH ST STE 164 AMMON, ID 83406 and the phone number is (208) 529-1795.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.