Brookshire Grocery Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BROOKSHIRE GROCERY COMPANY

Doing business as

Brookshires Pharmacy #123

Practice address

143 Plaza Drive Ext
Attention Pharmacy Dept
Brandon, MS 39047

Phone

(601) 992-6873

Fax

(601) 992-9615

NPI assigned

Nov 16, 2006

Last updated

Feb 27, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jim D Cousineau, RPH

Title

VP Pharmacy Operations

Phone

(903) 877-6829

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• BROOKSHIRES PHARMACY #123 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1194898429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1411",
            "address_2": "ATTENTION PHARMACY DEPT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757101411",
            "telephone_number": "601-992-6873",
            "fax_number": "903-877-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 PLAZA DRIVE EXT",
            "address_2": "ATTENTION PHARMACY DEPT",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "601-992-6873",
            "fax_number": "601-992-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "COUSINEAU",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "903-877-6829",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "03697 / 01.2",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330684",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2521121",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRES PHARMACY #123",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maegan Cook Bridges, NP-C
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• Allison Brister, OT
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• Christy Leigh Brooks, OTL
• Ronetta Broomfield
• Alexis Brown, PS-CSS
• Ashley Karol Brown, MD
• Corey Nathaniel Brown, DO
• Deandra Brown, OT

• Community/Retail Pharmacy in Brandon, MS
• Providers in Brandon, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.