# BROOKSHIRE GROCERY COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brookshire Pharmacy \#029
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023482304
- **Authorized official:** JIM COUSINEAU (SR. VP PHARMACY OPS)
- **Authorized official phone:** (903) 877-6829

## Contact information

- **Practice address:** 318 DIXIE PLZ, NATCHITOCHES, LA 71457-5880
- **Practice address phone:** (318) 352-3141
- **Mailing address:** 318 DIXIE PLZ, NATCHITOCHES, LA 71457-5880
- **Mailing address phone:** (318) 352-3141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY007217RC | LA | Yes |

## Other

- **Enumeration date:** 11/24/2015
- **Last updated:** 12/10/2015