Organization
BROULIM SUPERMARKETS, LLC
Active
Other names
Broulim's Pharmacy #9 - Shelley
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS C HURST PHARMD (PHARMACY DIRECTOR)
(208) 745-9201
Entity
Organization
Contact information
Practice address
570 S STATE ST, SHELLEY, ID 83274-1470
(208) 357-0473
(844) 721-6089
Mailing address
160 S CLARK ST, RIGBY, ID 83442-1407
(208) 745-9201
(208) 745-7433
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1307493
NCPDP
—
05
—
1396870911
—
ID
01
—
1876RP
BOARD OF PHARMACY
ID
Enumeration date
02/22/2007
Last updated
07/03/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us