# BROOKSHIRE GROCERY COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BROOKSHIRES PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851464325
- **Authorized official:** JIM COUSINEAU RPH (VP PHARMACY OPERATIONS)
- **Authorized official phone:** (903) 877-6514

## Contact information

- **Practice address:** 5696 HIGHWAY 1 BYP, ATTENTION PHARMACY DEPT, NATCHITOCHES, LA 71457-3254
- **Practice address phone:** (318) 214-0048
- **Practice address fax:** (318) 240-0790
- **Mailing address:** PO BOX 1411, TYLER, TX 75710-1411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.004728-RC | LA | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 12/22/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1269166 | — | LA |
| 01 | — | 2035051 | PK | — |