Brookshire Grocery Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BROOKSHIRE GROCERY COMPANY

Doing business as

BROOKSHIRES PHARMACY #121

Practice address

5841 Ridgewood Rd
Attention Pharmacy Dept
Jackson, MS 39211-2618

Phone

(601) 978-1747

Fax

(601) 978-3150

NPI assigned

Nov 15, 2006

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 #121 Doing business as

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1396818860",
    "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": "601-978-1747",
            "fax_number": "903-877-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 RIDGEWOOD RD",
            "address_2": "ATTENTION PHARMACY DEPT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112618",
            "telephone_number": "601-978-1747",
            "fax_number": "601-978-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "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": "05104 / 01.2",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2521107",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330682",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRES PHARMACY #121",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruth Joy Brooks
• Sarah Caroline Brooks, LCSW
• Spencer Brooks, NP
• Tami H. Brooks, M.D.
• Brookshire Grocery Company
• Sarah J Broom, MD
• Tamika M Broome, NP
• Broussard Behavioral Health Services LLC
• John Richard Brower
• Sonya M Brown-Gibson, FNP

• Community/Retail Pharmacy in Jackson, MS
• Providers in Jackson, 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.