Broulim Supermarkets, LLC
Broulim Supermarkets, LLC is a healthcare organization registered as Community/Retail Pharmacy in Rigby, ID, holding Type 2 (organization) NPI 1720132178 since 2007. The authorized official on file is Marcus Hurst, Pharmacy Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1720132178 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Broulim Supermarkets, LLC |
| Other name | <Unavail> |
| Practice address | 150 N STATE ST, Rigby, ID, 83442 |
| Phone | 2087450267 |
| Fax | 8662382549 |
| Enumeration date | 2007-01-23 |
| Last updated in NPPES | 2025-07-03 |
Authorized official
| Name | Marcus Hurst |
|---|---|
| Title | Pharmacy Director |
| Phone | 2087459201 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QP2300X | Primary Care Clinic/Center | Secondary | — | — |
| 3336C0002X | Clinic Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1305831 | Other | — | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 1912011 | Other | ID | MEDICARE NORIDIAN |
| 1720132178 | Medicaid | ID | — |
Copy-ready billing details
Provider: Broulim Supermarkets, LLC NPI: 1720132178 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 150 N STATE ST, Rigby, ID, 83442
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1528242807 | Jason Watts | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Rigby, ID |
| 1780937151 | Clinton Thackeray | Individual | Pharmacist | Rigby, ID |
| 1912319799 | Garret Portela | Individual | Pharmacist | Rigby, ID |
| 1316314842 | Marc Anderson | Individual | Pharmacist | Rigby, ID |
| 1083161186 | Nathaniel Brown | Individual | Pharmacist | Rigby, ID |
| 1891357802 | Oscar Waldo | Individual | Pharmacist | Rigby, ID |
Verify this record
Cross-check NPI 1720132178 against the authoritative CMS record: view Broulim Supermarkets, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Broulim Supermarkets, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-07-03.