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
208 N CENTRAL EXPY, ATTENTION PHARMACY DEPT, MCKINNEY, TX 75070-3518
(972) 548-7025
(972) 548-7235
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
16538
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2105021
PK
—
05
—
463960
—
TX
Enumeration date
11/15/2006
Last updated
08/10/2016
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