Provider Information for 1518030840
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
BROOKSHIRE GROCERY COMPANY
Other Names:Doing Business As:BROOKSHIRES PHARMACYOrganization Subpart: NO
NPI: 1518030840
Last Updated: 2016-08-10
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NPI | 1518030840 | ||||||||||||||||
Enumeration Date | 2006-11-16 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: JIM COUSINEAU RPH Title: VP PHARMACY OPERATIONS Phone: 9038776514 | ||||||||||||||||
Mailing Address | PO BOX 1409 CHANDLER, TX 75758-1409 United States Phone: | Fax: | ||||||||||||||||
Primary Practice Address | 703 HWY 31 EAST ATTENTION PHARMACY DEPT CHANDLER, TX 75758 United States Phone: 903-849-4090 | Fax:903-849-4129 | ||||||||||||||||
Secondary Practice Address(es) | |||||||||||||||||
Health Information Exchange |
| ||||||||||||||||
Other Identifiers |
| ||||||||||||||||
Taxonomy |
|