BROULIM SUPERMARKETS, LLC (NPI# 1659615078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659615078 |
| Entity Type | Organization |
| Organization Name | BROULIM SUPERMARKETS, LLC |
| Other Organization Name | BROULIMS PHARMACY |
| Practice Address |
141 N Washington St Afton WY 83110 |
| Mailing Address |
182 N State St Rigby ID 83442-1444 |
| Practice Telephone | 3078865550 |
| Practice Fax Number | 3078855057 |
| Mailing Telephone | 2087459201 |
| Mailing Fax Number | 2087457433 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | MARCUS C HURST (PHARMACY SUPERVISOR) |
| Authorized Official Telephone | 2087459201 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
R10090 | WY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | IMMUNIZATION SUPPLIER NSC | W25566 | 01 |
| WY | WY0157 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5204463 | 01 |
| Other Name | Type Code |
|---|---|
| Broulims Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669935813 | Broulim Supermarkets, LLC | Pharmacy | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2019-04-12 |
| 1396870911 | Broulim Supermarkets, LLC | Pharmacy | 570 S State St, Shelley, ID 83274-1470 | 2007-02-22 |
| 1720132178 | Broulim Supermarkets, LLC | Pharmacy | 150 N State St, Rigby, ID 83442-1443 | 2007-01-23 |
| 1487117636 | Broulim Supermarkets, LLC | Pharmacy | 1855 W Broadway St, Idaho Falls, ID 83402-3043 | 2019-04-12 |
| 1851854095 | Broulim Supermarkets, LLC | Pharmacy | 3160 E 17th St Ste 164, Ammon, ID 83406-6784 | 2019-04-12 |
| 1336517861 | Broulim Supermarkets, LLC | Pharmacy | 2730 E Sunnyside Rd, Ammon, ID 83406-7547 | 2015-09-15 |
| 1427101674 | Broulim Supermarkets, LLC | Pharmacy | 240 S Main St, Driggs, ID 83422-5401 | 2007-01-19 |
| Street Address |
141 N WASHINGTON ST |
| City | AFTON |
| State | WY |
| Zip Code | 83110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235402132 | Afton Family Pharmacy | Pharmacy | 141 N Washington St, Afton, WY 83110 | 2012-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487269569 | Allred Performance and Rehabilitation LLC | Physical Therapist | 533 Allred Rd, Afton, WY 83110 | 2020-09-15 |
| 1427691211 | Rhet Mitchell Long | Pharmacist | 307 S Washington, Afton, WY 83110 | 2019-10-24 |
| 1609425859 | Cori Anderson | Physician Assistant | 47 Doc Perkes Ln, Afton, WY 83110 | 2019-09-10 |
| 1649737560 | Our Valley Pharmacy | Pharmacy | 307 South Washington, Afton, WY 83110 | 2019-02-27 |
| 1073090585 | Star Valley Healthcare, Inc. | Home Health | 625 S Washington St, Ste B, Afton, WY 83110 | 2018-07-26 |
| 1669962247 | Easy Access LLC. | Durable Medical Equipment & Medical Supplies | 152 Hillview Dr., Afton, WY 83110 | 2018-05-18 |
| 1457890659 | Beyond Home Living, LLC | Assisted Living Facility | 153 Doyle Child Circle, Afton, WY 83110 | 2017-02-21 |
| 1396294914 | Jamie Armstrong | Speech-Language Pathologist | 675 Washington, Afton, WY 83110 | 2016-09-23 |
| 1295184398 | Northwest Home Health LLC | Home Health | 422 South Washington, Ste F, Afton, WY 83110 | 2016-06-09 |
| 1811363955 | Ashley Hall | Registered Nurse | 125 South Washington, Afton, WY 83110 | 2015-08-12 |
| Find all providers in zip 83110 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235402132 | Afton Family Pharmacy | Pharmacy | 141 N Washington St, Afton, WY 83110 | 2012-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306484092 | Compounding Specialists LLC | Pharmacy | 1540 Centennial Ct Unit 100, Casper, WY 82609-7308 | 2019-12-13 |
| 1710535216 | Spamony20 LLC | Pharmacy | 150 E Hart St, Buffalo, WY 82834-1705 | 2019-08-28 |
| 1689136038 | Cvs Pharmacy Inc | Pharmacy | 1708 Dell Range Blvd, Cheyenne, WY 82009-4945 | 2019-04-04 |
| 1902365240 | Worland Pharmacy Inc. | Pharmacy | 1095 Circle Rd, Worland, WY 82401 | 2019-03-17 |
| 1285140376 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 | 2017-12-27 |
| 1922514017 | Bear Lake Community Health Center | Pharmacy | 2620 Commercial Way Ste 121, Rock Springs, WY 82901-4746 | 2017-12-27 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1487047122 | Glenrock Hsopital District | Pharmacy | 925 West Birch, Glenrock, WY 82637-0786 | 2015-03-05 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1861789646 | Geneva Woods Retail Pharmacy, LLC | Pharmacy | 1522 East A St, Casper, WY 82601-2217 | 2011-06-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.