Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
BROOKSHIRES 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
703 HWY 31 EAST, ATTENTION PHARMACY DEPT, CHANDLER, TX 75758
(903) 849-4090
(903) 849-4129
Mailing address
PO BOX 1409, CHANDLER, TX 75758-1409
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17514
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144538
—
TX
01
—
2106653
PK
—
05
—
466126
—
TX
Enumeration date
11/16/2006
Last updated
08/10/2016
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