Brookshire Grocery Company
Organization Active NPI Community/Retail Pharmacy · Opelousas, LA
NPI 1679646145 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1679646145
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 005578 (LA)
- Legal business name
- BROOKSHIRE GROCERY COMPANY
- Practice address
- 2418 S Union St
Attention Pharmacy Dept
Opelousas, LA 70570-5735 - Phone
- (337) 942-3674
- Fax
- (337) 948-7560
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Jim Cousineau, RPH
- Title
- VP Pharmacy Operations
- Phone
- (903) 877-6514
Other NPIs on the same Medicare enrollment 38
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091104000210 | LA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1355415712 |
38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shreveport, LA; Monroe, LA; Natchitoches, LA; New Iberia, LA; New Roads, LA; Opelousas, LA; Pineville, LA; Ruston, LA… |
National Provider Directory
Locations
2418 S Union St
Opelousas, LA 70570
Phone (337) 942-3671
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 005578 | LA | Yes |
Addresses
Primary practice location
2418 S Union St
Attention Pharmacy Dept
Opelousas, LA 70570-5735
Mailing address
2418 South Union
Attention Pharmacy Dept
Opelousas, LA 70570
Phone (337) 942-3674
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1287709 | Medicaid | LA | |
| 2035296 | Other | PK |
Other names
- SUPER 1 PHARMACY
Other providers in Opelousas, LA
- Laura Richard Braham
- Julissa Braimoh
- Emily Breaux
- Melissa Martin Breaux
- BRN Inc.
- Gannon G Brouillette
- Adeline Broussard
- Christopher Broussard
- Theaolecia Broussard
- Tracy P Broussard
All providers in Opelousas, LA · Community/Retail Pharmacy in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.