Organization
BROOKSHIRE GROCERY COMPANY
Active
Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Brookshire Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU (VICE PRESIDENT OF PHARMACY OPERATIO)
(903) 877-6829
Entity
Organization
Contact information
Practice address
125 HALL RD, SEAGOVILLE, TX 75159-2915
(972) 287-1680
(972) 287-2269
Mailing address
PO BOX 1411, PHARMACY DEPT, TYLER, TX 75710-1411
(972) 287-1680
(972) 287-2269
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122105
PK
—
Enumeration date
10/01/2009
Last updated
07/15/2015
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