BROOKSHIRE GROCERY COMPANY (NPI# 1215000781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215000781 |
Entity Type | Organization |
Organization Name | BROOKSHIRE GROCERY COMPANY |
Other Organization Name | BROOKSHIRES PHARMACY |
Practice Address |
1117 Polk St Attention Pharmacy Dept Mansfield LA 71052-2524 |
Mailing Address |
1600 W Sw Loop 323 Po Box 1411 Tyler TX 75701-8532 |
Practice Telephone | 3188712976 |
Practice Fax Number | 3188712977 |
Mailing Telephone | 9038776827 |
Mailing Fax Number | 9038773820 |
Enumeration Date | 2006-11-15 |
Last Update Date | 2015-12-22 |
Authorized Official Name | JIM COUSINEAU (VP PHARMACY OPERATIONS) |
Authorized Official Telephone | 9038776514 |
Authorized Official Credential | RPH |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
4038 | LA | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2033747 | 01 | |
LA | 1266043 | 05 |
Other Name | Type Code |
---|---|
BROOKSHIRES PHARMACY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386147627 | Brookshire Grocery Company | Pharmacy | 420 Hospital Rd, New Roads, LA 70760-2623 | 2018-03-13 |
1295248672 | Brookshire Grocery Company | Pharmacy | 1500 Bonin Rd, Youngsville, LA 70592-5102 | 2017-11-08 |
1750811295 | Brookshire Grocery Company | Pharmacy | 200 Destination Pointe Ln., Scott, LA 70583 | 2017-06-18 |
1962874602 | Brookshire Grocery Company | Pharmacy | 172 Centennial Pkwy, Tyler, TX 75703 | 2015-10-21 |
1033592514 | Brookshire Grocery Company | Pharmacy | 1801 N 18th St, Monroe, LA 71201-4401 | 2015-07-02 |
1518300086 | Brookshire Grocery Company | Pharmacy | 2300 W Ennis Ave, Ennis, TX 75119-8039 | 2013-04-15 |
1710227202 | Brookshire Grocery Company | Pharmacy | 11205 N Hwy 289, Pottsboro, TX 75076 | 2013-02-21 |
1538407416 | Brookshire Grocery Company | Pharmacy | 1001 Joshua Station Boulevard, Joshua, TX 76058 | 2013-01-28 |
1487907051 | Brookshire Grocery Company | Pharmacy | 1200 S 3rd St, Mabank, TX 75147-7679 | 2012-10-19 |
1003182122 | Brookshire Grocery Company | Pharmacy | 3916 Ne Evangeline Trwy, Carencro, LA 70520-5972 | 2012-03-23 |
Entity Type | Entity Name | Entity Address |
---|---|---|
North Carolina Corporations | Brookshire Grocery Company | 2 South Salisbury Street, Raleigh, NC 27601 |
Washington State Corporations | BROOKSHIRE GROCERY COMPANY | 505 Union Ave Se Ste 120, Olympia, WA 98501 |
Street Address |
1117 POLK ST ATTENTION PHARMACY DEPT |
City | MANSFIELD |
State | LA |
Zip Code | 71052-2524 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932750411 | Jameia Waggoner | Pharmacist | 1117 Polk St, Mansfield, LA 71052-2524 | 2019-09-25 |
1467725408 | Wanda Anderson Hanna | Pharmacist | 1117 Polk St, Mansfield, LA 71052-2524 | 2012-02-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689186421 | Bridgette Williams | Counselor | 419 Washington Street, Mansfield, LA 71052 | 2017-11-02 |
1922527217 | Cherlyndria Wyatt | Counselor | 108 Hope St, Mansfield, LA 71052 | 2017-09-18 |
1619342433 | Stanley Cunningham | Counselor | 125 Canary Lane, Mansfield, LA 71052 | 2015-12-04 |
1578936480 | Comiseia Jones | Counselor | 2102 N Park Ave, Mansfield, LA 71052 | 2015-11-02 |
1932571023 | Elichia Bennett | Counselor | 584 Antioch Rd, Mansfield, LA 71052 | 2015-10-28 |
1912378597 | Angela Mcintyre | Case Manager/Care Coordinator | 162 Division St, Mansfield, LA 71052 | 2015-10-08 |
1144690645 | Edwina Elrod Eley | Nurse Practitioner | 7356 Highway 509, Mansfield, LA 71052 | 2015-09-28 |
1760746176 | Amy Melton Robbins | Occupational Therapist | 558 Turner Robbins Rd, Mansfield, LA 71052 | 2012-06-29 |
1811209232 | Desoto Healthcare Center Inc. | Internal Medicine | 938 Louise St, Mansfield, LA 71052 | 2010-07-14 |
1174786263 | Frances Jackson | Speech-Language Pathologist | 508 Rea Street, Mansfield, LA 71052 | 2008-07-08 |
Find all providers in zip 71052 |
Taxonomy Code | 3336C0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Community/Retail Pharmacy |
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316439748 | Ambika Pharmacy LLC | Pharmacy | 2300 Matlock Rd Ste 37, Mansfield, TX 76063-5018 | 2018-06-01 |
1992104194 | Shatiff Pharmacy Inc | Pharmacy | 2771 E Broad St Ste 219, Mansfield, TX 76063-9157 | 2014-08-14 |
1124459870 | Melrose Pharmacy LLC | Pharmacy | 2860 Highway 157 N Ste 120, Mansfield, TX 76063-8883 | 2013-12-06 |
1205922457 | Coles Pharmacy | Pharmacy | 2 S Main Street, Mansfield, PA 16933-1508 | 2006-10-05 |
1043311509 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 197 N Main St, Mansfield, PA 16933-1311 | 2006-09-26 |
1467551838 | Cvs Pharmacy Inc | Pharmacy | 261 Chauncy St, Mansfield, MA 02048-1247 | 2006-09-22 |
1427156272 | Cvs Pharmacy Inc | Pharmacy | 2882 N Fm 157, Mansfield, TX 76063 | 2006-09-20 |
1245334036 | Cvs Pharmacy Inc | Pharmacy | 1100 N Walnut Creek Dr, Mansfield, TX 76063-2502 | 2006-09-12 |
1063515765 | Ohio Cvs Stores LLC | Pharmacy | 1411 Lexington Ave, Mansfield, OH 44907-2629 | 2006-09-07 |
1679588644 | Walgreen Co | Pharmacy | 750 N Walnut Creek Dr, Mansfield, TX 76063-3208 | 2006-07-29 |
Find all providers in MANSFIELD |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.