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
675 E SUNSET BLVD, ATTENTION PHARMACY DEPT, CELINA, TX 75009-4017
(972) 382-3989
(972) 382-8902
Mailing address
PO BOX 1411, TYLER, TX 75710-1411
(903) 877-6827
(903) 877-6909
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
24974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099368
PK
—
05
—
466304
—
TX
Enumeration date
11/16/2006
Last updated
03/29/2016
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