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
1603 CULVER ST, ATTENTION PHARMACY DEPT, COMMERCE, TX 75428-3422
(903) 886-2867
(903) 886-2923
Mailing address
1600 W SW LOOP 323, PO BOX 1411, TYLER, TX 75701-8532
(903) 877-6827
(903) 877-3820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17501
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144539
—
TX
01
—
2106651
PK
—
05
—
466124
—
TX
Enumeration date
11/15/2006
Last updated
01/06/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us