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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