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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: August 09, 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
Phone(208) 529-1795
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
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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

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

Areas of Expertise CMS Part B claims 2

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.
79 services76 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.
49 services49 patients

Other Providers at the Same Location NPPES 5

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

JACEE CLARK PHARMD
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Bonneville County (208) 529-1795
DR. JOSEPH MICHAEL BROWN PHARMD
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Bonneville County (208) 529-1795
KYREN TWEEDIE
Student in an Organized Health Care Education/Training Program
3160 E 17TH ST STE 164
AMMON, ID 83406
Bonneville County (208) 529-1795
TETON PHARMACY IN AMMON
Pharmacy (Community/Retail Pharmacy)
3160 E 17TH ST STE 164
AMMON, ID 83406
Bonneville County (208) 529-1795
JARED K LYON PHARMD., RPH
Pharmacist
3160 E 17TH ST STE 164
AMMON, ID 83406
Bonneville County (208) 529-1795

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 1851854095. It was assigned to this organization in the NPPES registry on April 12, 2019. The provider is doing business as Broulim's Pharmacy #17 - 17th Street.

Where is Broulim Supermarkets, LLC located?

Broulim Supermarkets, LLC is located at 3160 E 17th St Ste 164, Ammon, ID 83406. The listed phone number is (208) 529-1795.

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.

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 Arizona Complete Health and 49 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 13 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.