Brookshires Pharmacy #121

LBN: Brookshire Grocery Company
Brookshires Pharmacy #121 is an health care organization with primary practice located at 5841 Ridgewood Rd Attention Pharmacy Dept, Jackson MS 39211-2618. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Brookshire Grocery Company can be contacted via phone (601) 978-1747, or through Cousineau, Jim D via phone (903) 877-6829.

Contact Information

Primary practice address
5841 Ridgewood Rd Attention Pharmacy Dept Jackson MS 39211-2618
Phone: (601) 978-1747
Fax: (601) 978-3150
Website:
Map and Directions
Authorized official contact:
Name: Cousineau, Jim D RPH
Phone: (903) 877-6829

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 05104 / 01.2 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1396818860
LBN Legal business name Brookshire Grocery Company
DBA Doing business as Brookshires Pharmacy #121
Authorized official Cousineau, Jim D RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2006
Last updated Feb 27th, 2008 - about 16 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 1396818860 NPPES
Other 2521107 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 0330682 OTHER ID NUMBER-COMMERCIAL NUMBER

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