# BROOKSHIRE GROCERY COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brookshire Pharmacy \#034
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033592514
- **Authorized official:** JIM COUSINEAU (SR. VP PHARMACY OPS)
- **Authorized official phone:** (903) 877-6829

## Contact information

- **Practice address:** 1801 N 18TH ST, MONROE, LA 71201-4401
- **Practice address phone:** (318) 340-6470
- **Practice address fax:** (318) 340-6473
- **Mailing address:** PO BOX 1411, TYLER, TX 75710-1411
- **Mailing address phone:** (903) 877-6863
- **Mailing address fax:** (903) 877-3820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 007138 | LA | Yes |

## Other

- **Enumeration date:** 07/02/2015
- **Last updated:** 07/22/2015