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Organization

BROOKSHIRE GROCERY COMPANY

Active
Other names
Brookshire Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JIM COUSINEAU (VP PHARMACY OPERATIONS)
(903) 877-6862
Entity
Organization

Contact information

Practice address
880 E STATE HIGHWAY 243, CANTON, TX 75103
(903) 567-2403
(903) 567-4801
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
26062
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4550453
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
12/05/2008
Last updated
11/06/2012
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