Brookshire Grocery Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

23004 Issued in TX

Legal business name

BROOKSHIRE GROCERY COMPANY

Doing business as

BROOKSHIRES PHARMACY

Practice address

210 N McCoy Blvd
Attention Pharmacy Dept
New Boston, TX 75570-3025

Phone

(903) 628-7459

Fax

(903) 628-7462

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 Cousineau, RPH

Title

VP Pharmacy Operations

Phone

(903) 877-6514

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BROOKSHIRES PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1730252206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W SW LOOP 323",
            "address_2": "PO BOX 1411",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018532",
            "telephone_number": "903-877-6827",
            "fax_number": "903-877-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MCCOY BLVD",
            "address_2": "ATTENTION PHARMACY DEPT",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755703025",
            "telephone_number": "903-628-7459",
            "fax_number": "903-628-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "COUSINEAU",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "VP PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "903-877-6514",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "23004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2096480",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465570",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey P Atkinson, DDS
• James K Barfield, D.D.S.
• Wade Batchelor, PT
• BDS Global LLC
• Charity Bennett-Kinney, PHD, LPC
• Andrea Brown, NP-C
• Melissa L Bush
• Jennifer Lee Campbell, LPC
• Jared Dale Clark, APN
• Thomas Miller Coleman III, PHARM D.

• Community/Retail Pharmacy in New Boston, TX
• Providers in New Boston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.