Super 1 Pharmacy #643

LBN: Brookshire Grocery Company
Super 1 Pharmacy #643 is an health care organization with primary practice located at 200 Destination Pointe Ln. , Scott LA 70583. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Brookshire Grocery Company can be contacted via phone (337) 210-2001, or through Cousineau, Jim via phone (903) 877-6829.

Contact Information

Primary practice address
200 Destination Pointe Ln. Scott LA 70583
Phone: (337) 210-2001
Fax: (337) 236-6531
Website:
Map and Directions
Authorized official contact:
Name: Cousineau, Jim
Phone: (903) 877-6829

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 007485 Louisiana
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1750811295
LBN Legal business name Brookshire Grocery Company
DBA Doing business as Super 1 Pharmacy #643
Authorized official Cousineau, Jim
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2017
Last updated Jun 18th, 2017 - about 7 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 1750811295 NPPES
Other 2169752 PK

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