Brookshire Grocery Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25507 Issued in TX

Legal business name

BROOKSHIRE GROCERY COMPANY

Doing business as

Brookshire Pharmacy

Practice address

1105 W South Commerce St
Wills Point, TX 75169-2355

Phone

(903) 873-8237

Fax

(903) 873-8732

NPI assigned

Apr 24, 2007

Last updated

Nov 1, 2012By 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 Cousineau

Title

VP PHRM Oper

Phone

(903) 877-6829

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BROOKSHIRE 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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1730308503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1411",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757101411",
            "telephone_number": "903-877-6862",
            "fax_number": "903-877-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W SOUTH COMMERCE ST",
            "city": "WILLS POINT",
            "state": "TX",
            "postal_code": "751692355",
            "telephone_number": "903-873-8237",
            "fax_number": "903-873-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "COUSINEAU",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "VP PHRM OPER",
        "authorized_official_telephone_number": "903-877-6829"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4544602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tamera Armstrong, RPH
• Telitha Aline Baker, RN
• BHRX LLC (Bruce and Human Drug)
• Lysianne Seigler Boone, MT
• Gina Gay Borgognoni
• Sheila Kaye Brown, LM, CPM
• City of Wills Point
• City of Wills Point EMS
• Elizabeth Ann Collins-Lee, LPC
• Cosmic Home Healthcare Inc. (New Life Home Healthcare)

• Community/Retail Pharmacy in Wills Point, TX
• Providers in Wills Point, 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 Nov 1, 2012; 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.