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Organization
BROOKSHIRE GROCERY COMPANY
Active
Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Super One
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU (SR. VP PHARMACY OPS)
(903) 877-6829
Entity
Organization
Contact information
Practice address
3916 NE EVANGELINE TRWY, CARENCRO, LA 70520-5972
(337) 886-3660
(337) 886-3661
Mailing address
3916 NE EVANGELINE THRUWAY, CARENCRO, LA 70520
(337) 886-3660
(337) 886-3661
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006495-RC
LA
Other
Enumeration date
03/23/2012
Last updated
09/19/2025
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