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Organization

BROOKSHIRE GROCERY COMPANY

Active
Other names
SUPER 1 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
2418 S UNION ST, ATTENTION PHARMACY DEPT, OPELOUSAS, LA 70570-5735
(337) 942-3674
(337) 948-7560
Mailing address
2418 SOUTH UNION, ATTENTION PHARMACY DEPT, OPELOUSAS, LA 70570
(337) 942-3674
(337) 948-7560

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
005578
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1287709
LA
01
2035296
PK
Enumeration date
11/15/2006
Last updated
09/19/2025
About Stedi
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  • Eligibility checks
  • EDI platform