Organization
BROOKSHIRE GROCERY COMPANY
Active
Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Brookshire Pharmacy #127
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU (SR VP PHARMACY OPS)
(903) 877-6829
Entity
Organization
Contact information
Practice address
11205 N HWY 289, POTTSBORO, TX 75076
(903) 786-3150
(903) 786-3166
Mailing address
11205 N HWY 289, POTTSBORO, TX 75076
(903) 877-6827
(903) 877-3820
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138889
PK
—
Enumeration date
02/21/2013
Last updated
12/17/2014
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