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BROULIM SUPERMARKETS, LLC

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Company Details

Name: BROULIM SUPERMARKETS, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 02 Jun 2010 (15 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 290998
Place of Formation: IDAHO
File Number: 290998
ZIP code: 83442
County: Jefferson County
Principal Address: 182 N STATE ST RIGBY, ID 83442
Mailing Address: 160 S STATE ST RIGBY, ID 83442-1448

Agent

Name Role Address
ROBERT W BROULIM Agent 426 N 4200 E, ROBERT BROULIM, RIGBY, ID 83442

Manager

Name Role Address Appointed On
Robert W Broulim Manager 426 N 4200E, RIGBY, ID 83442 2020-07-02

National Provider Identifier

NPI Number:
1366275638
Certification Date:
2025-02-19

Authorized Person:

Name:
MARCUS C HURST
Role:
PHARMACY DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2087453431

Filing

Filing Name Filing Number Filing date
Annual Report 0006262269 2025-05-21
Annual Report 0005724188 2024-05-06
Annual Report 0005267488 2023-06-05
Annual Report 0004736352 2022-05-05
Annual Report 0004266964 2021-05-04

Motor Carrier Census

DBA Name:
BROULIM SUPERMARKETS
Carrier Operation:
Interstate
Fax:
(208) 745-7801
Add Date:
2005-11-04
Operation Classification:
Private(Property)
power Units:
1
Drivers:
2
Inspections:
1
FMCSA Link:

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Date of last update: 31 May 2025

Sources: Idaho Secretary of State