Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Super 1 Foods PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU RPH (VP PHARMACY OPERATIONS)
(903) 877-6514
Entity
Organization
Contact information
Practice address
2800 S HAZEL ST, ATTENTION PHARMACY DEPT, PINE BLUFF, AR 71603-5007
(870) 535-4044
(870) 535-8116
Mailing address
2800 SOUTH HAZEL STREET, ATTENTION PHARMACY DEPT, PINE BLUFF, AR 71603
(870) 535-4044
(870) 535-8116
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0420004
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130898407
—
AR
01
—
1988193
PK
—
Enumeration date
11/15/2006
Last updated
09/19/2025
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