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BROOKSHIRE GROCERY COMPANY NPI 1093888562


NPI Information

NPI: 1093888562
Provider Name: BROOKSHIRE GROCERY COMPANY

Doing Business As: SUPER 1 PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 45D2183818

Address:
2610 RICHMOND RD
ATTENTION PHARMACY DEPT
TEXARKANA, TX
ZIP 75503
Phone: (903) 832-2258
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BROOKSHIRE GROCERY COMPANY is a community/retail pharmacy pharmacy in Texarkana, TX. 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 1093888562. 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:

2610 RICHMOND RD
ATTENTION PHARMACY DEPT
TEXARKANA, TX
ZIP 75503-327
Phone: (903) 832-2258
Fax: (903) 832-2451

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 45D2183818 - 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 5/5/2016.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy15462TEXASYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12100929OTHERPK
21012120063MEDICARE NSC
3463944MEDICAIDTEXAS

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.