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BROOKSHIRE GROCERY COMPANY NPI 1699848168


NPI Information

NPI: 1699848168
Provider Name: BROOKSHIRE GROCERY COMPANY

Doing Business As: SUPER 1 PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 04D2183776

Address:
909 N HERVEY ST
ATTENTION PHARMACY DEPT
HOPE, AR
ZIP 71801
Phone: (870) 777-6989
Get Directions

BROOKSHIRE GROCERY COMPANY is a community/retail pharmacy pharmacy in Hope, AR. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. BROOKSHIRE GROCERY COMPANY NPI is 1699848168. The provider is registered as an organization entity type.
The provider Is Doing Business As Super 1 Pharmacy.

The provider's business location address is:

909 N HERVEY ST
ATTENTION PHARMACY DEPT
HOPE, AR
ZIP 71801-613
Phone: (870) 777-6989
Fax: (870) 777-6057

The provider's authorized official is Jim Cousineau .
The authorized official title is Vp Pharmacy Operations and has the following contact phone number (903) 877-6514.

The CLIA number assigned to this NPI record is 04D2183776 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 12/15/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy0418485ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1125611407MEDICAIDARKANSAS
21995486OTHERPK
31012120011MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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