BROULIM SUPERMARKETS, LLC (NPI# 1851854095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851854095 |
| Entity Type | Organization |
| Organization Name | BROULIM SUPERMARKETS, LLC |
| Practice Address |
3160 E 17th St Ste 164 Ammon ID 83406-6784 |
| Mailing Address |
182 N State St Rigby ID 83442-1444 |
| Practice Telephone | 2085291795 |
| Mailing Telephone | 2087459201 |
| Mailing Fax Number | 2087457433 |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2019-05-03 |
| Authorized Official Name | DR. 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 | 333600000X | Pharmacy | Suppliers |
| 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 |
| 1336517861 | Broulim Supermarkets, LLC | Pharmacy | 2730 E Sunnyside Rd, Ammon, ID 83406-7547 | 2015-09-15 |
| 1659615078 | Broulim Supermarkets, LLC | Pharmacy | 141 N Washington St, Afton, WY 83110 | 2012-11-26 |
| 1427101674 | Broulim Supermarkets, LLC | Pharmacy | 240 S Main St, Driggs, ID 83422-5401 | 2007-01-19 |
| Street Address |
3160 E 17TH ST STE 164 |
| City | AMMON |
| State | ID |
| Zip Code | 83406-6784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831561034 | Teton Pharmacy In Ammon | Pharmacy | 3160 E 17th St Ste 164, Ammon, ID 83406-6784 | 2015-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383929 | Cristina Leon, Do Pa | Pediatrics | Idaho Falls Pediatrics, 3067 Eagle Dr, Ammon, ID 83406 | 2020-07-13 |
| 1144783499 | Mountain States Diabetes Relief, LLC | Internal Medicine | 4573 E Majestic, Idaho Falls, ID 83406 | 2019-04-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| 1225379183 | Sterling Hospital LLC | General Acute Care Hospital | 5412 S. Rock House Cir, Idaho Falls, ID 83406 | 2013-03-01 |
| 1710236823 | Flower D. Aston | Dietitian, Registered | 300 Bridger Drive, Ammon, ID 83406 | 2012-09-05 |
| 1558658468 | Nathan Myers | Pharmacist | 1901 South 2500 East, Idaho Falls, ID 83406 | 2011-06-30 |
| 1760719934 | Snf Ammon Operating Company LLC. | Skilled Nursing Facility | 3909 South 25th East, Ammon, ID 83406 | 2009-11-10 |
| 1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
| 1992968804 | Brandon D Gordon | Dentist | 7186 Sage View Cr, Idaho Falls, ID 83406 | 2008-07-10 |
| 1891996526 | Help, Inc. | Community/Behavioral Health | 1465 Hoopes Ave, Idaho Falls, ID 83406 | 2007-05-30 |
| Find all providers in zip 83406 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386202026 | Genoa Healthcare, LLC | Pharmacy | 2705 E 17th St Ste S5, Ammon, ID 83406-6601 | 2019-05-29 |
| 1740265420 | Pharmease LLC | Pharmacy | 3250 E 17th St, Ammon, ID 83406-6758 | 2005-12-14 |
| 1609800937 | Eastgate Drug | Pharmacy | 3250 E 17th St, Ammon, ID 83406-6758 | 2006-07-11 |
| 1689605735 | K Mart Corp | Pharmacy | 3101 E 17th St, Ammon, ID 83406-6717 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043878598 | Legranderx Pharmacy LLC | Pharmacy | 343 E 4th N Ste 126, Rexburg, ID 83440-6004 | 2019-05-30 |
| 1669935813 | Broulim Supermarkets, LLC | Pharmacy | 301 Aspen Sq, Saint Anthony, ID 83445-1662 | 2019-04-12 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1881194090 | Doc's Pharmacy2 LLC | Pharmacy | 16438 N Highway 41, Rathdrum, ID 83858-6888 | 2018-02-14 |
| 1508365958 | P. Roman Burk Dpm PC | Pharmacy | 2667 E. Gala Court Suite 125, Meridian, ID 83642 | 2018-02-12 |
| 1053860767 | Gooding Pharmacy Inc | Pharmacy | 120 South Apple, Suite A, Shoshone, ID 83352 | 2016-09-23 |
| 1649644584 | Yokes Foods Inc | Pharmacy | 1501 E Seltice Way, Post Falls, ID 83854-7531 | 2015-11-16 |
| 1629452776 | Shopko Stores Operating Co., LLC | Pharmacy | 429 Michigan Ave, Orofino, ID 83544-0000 | 2015-07-17 |
| 1164811402 | Ashton Memorial, Inc | Pharmacy | 23 S. 8th St., Ashton, ID 83420 | 2015-01-09 |
| 1053742577 | Gemstate Pharmacy Group Inc | Pharmacy | 800 S Industry Way Ste 330, Meridian, ID 83642-3598 | 2013-12-09 |
| 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.