Broulim Supermarkets, LLC

NPI #1366275638 in Rigby, Idaho

Provider Information

NPI Number: 1366275638
Entity Type: Organization
Organization Name: Broulim Supermarkets, LLC
Primary Specialty: Clinic/Center - Health Service
Enumeration Date: Aug 22, 2024
Last Updated: Feb 19, 2025

Practice Location

Address: 160 S CLARK ST
City: Rigby
State: Idaho
ZIP Code: 83442-1407
Phone: (208) 745-9201

Authorized Official

Name: MARCUS C HURST, PHARMD
Title: PHARMACY DIRECTOR
Phone: (208) 745-9201

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Health Service — Health Service	261QH0100X	Primary

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