Super 1 Pharmacy

LBN: Brookshire Grocery Company
Super 1 Pharmacy is an health care organization with primary practice located at 2610 Richmond Rd Attention Pharmacy Dept, Texarkana TX 75503-2327. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Brookshire Grocery Company can be contacted via phone (903) 832-2258, or through Cousineau, Jim via phone (903) 877-6514.

Contact Information

Primary practice address
2610 Richmond Rd Attention Pharmacy Dept Texarkana TX 75503-2327
Phone: (903) 832-2258
Fax: (903) 832-2451
Website:
Map and Directions
Authorized official contact:
Name: Cousineau, Jim RPH
Phone: (903) 877-6514

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 15462 Texas

Profile Details

NPI number 1093888562
LBN Legal business name Brookshire Grocery Company
DBA Doing business as Super 1 Pharmacy
Authorized official Cousineau, Jim RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2006
Last updated May 5th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093888562 NPPES
Other 2100929 PK
MEDICAID 463944 PK

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