Organization
BROOKSHIRE GROCERY COMPANY
Active
Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
BROOKSHIRE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COUSINEAU RPH (VP OF PHCY OPER)
(903) 877-6829
Entity
Organization
Contact information
Practice address
1705 W AUDIE MURPHY PKWY, FARMERSVILLE, TX 75442-2752
(972) 782-8601
(972) 782-8618
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
25520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4545301
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/09/2007
Last updated
11/01/2012
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