Brookshire Grocery Company

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

21446 Issued in TX

Legal business name

BROOKSHIRE GROCERY COMPANY

Practice address

1477 N Beaulah St
Attention Pharmacy Dept
Hawkins, TX 75765-3111

Phone

(903) 769-3344

Fax

(903) 769-2885

NPI assigned

Nov 16, 2006

Organization subpart

No

Name

Jim Cousineau, RPH

Title

VP Pharmacy Operations

Phone

(903) 877-6514

• BROOKSHIRES PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 10, 2015.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1801969134",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 N BEAULAH ST",
            "address_2": "ATTENTION PHARMACY DEPT",
            "city": "HAWKINS",
            "state": "TX",
            "postal_code": "757653111",
            "telephone_number": "903-769-3344",
            "fax_number": "903-769-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE GROCERY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-12-10",
        "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": "21446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465167",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca A Alexander
• Jacob Dean Andersen, DMD
• Francisco Armando Arredondo
• Shane M Bogard
• Frankie Lynn Brown, LVN
• Jaimie Burson
• Carroll Partners Investment Inc
• Christus Trinity Clinic Texas
• Mary Leann Clowers, LVN

• All providers in Hawkins, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.