Super 1 Pharmacy
LBN: Brookshire Grocery Company
Super 1 Pharmacy is an health care organization with primary practice located at 1870 Airline Dr Attention Pharmacy Dept, Bossier City LA 71112-2702. 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 (318) 746-8401, or through Cousineau, Jim via phone (903) 877-6514.
Contact Information
Primary practice address
1870 Airline Dr Attention Pharmacy Dept
Bossier City LA 71112-2702
Phone: (318) 746-8401
Fax: (318) 746-8401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 3291 | Louisiana |
Profile Details
| NPI number | 1770656241 |
|---|---|
| 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 | Dec 22nd, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770656241 | NPPES |
| Louisiana | MEDICAID | 1263273 | |
| Louisiana | Other | 2033530 |
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