Organization
BROOKSHIRE GROCERY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM D COUSINEAU (VP PHARMACY OPERATIONS)
(903) 877-6829
Entity
Organization
Contact information
Practice address
1600 WSW LOOP 323, TYLER, TX 75701-8532
(903) 877-6827
Mailing address
PO BOX 911439, DALLAS, TX 75391-1439
(903) 877-6827
(903) 877-6909
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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