Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Brookshire Pharmacy #133
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU (SR VP PHARMACY OPS)
(903) 877-6829
Entity
Organization
Contact information
Practice address
1001 JOSHUA STATION BOULEVARD, JOSHUA, TX 76058
(817) 556-2389
(817) 556-2399
Mailing address
PO BOX 1411, TYLER, TX 75710-1411
(903) 877-6827
(903) 877-3820
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28378
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138612
PK
—
Enumeration date
01/28/2013
Last updated
06/02/2014
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