BROOKSHIRE GROCERY COMPANY (NPI# 1518300086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518300086 |
| Entity Type | Organization |
| Organization Name | BROOKSHIRE GROCERY COMPANY |
| Other Organization Name | BROOKSHIRE PHARMACY #88 |
| Practice Address |
2300 W Ennis Ave Ennis TX 75119-8039 |
| Mailing Address |
Po Box 1411 Tyler TX 75710-1411 |
| Practice Telephone | 9728754607 |
| Practice Fax Number | 9728752060 |
| Mailing Telephone | 9038776827 |
| Mailing Fax Number | 9038773820 |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2013-07-30 |
| Authorized Official Name | JIM COUSINEAU (SR VP PHARMACY OPS) |
| Authorized Official Telephone | 9038776829 |
| 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 |
28377 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2139824 | 01 |
| Other Name | Type Code |
|---|---|
| Brookshire Pharmacy #88 | 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 |
| 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 |
| 1083910137 | Brookshire Grocery Company | Pharmacy | 6991 Old Jacksonville Hwy, Tyler, TX 75703-0579 | 2011-02-08 |
| 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 |
2300 W ENNIS AVE |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-8039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| 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 |
|---|---|---|---|---|
| 1346859071 | Ennis Specialty Pharmacy, Inc | Pharmacy | 601 S Clay St Ste 108, Ennis, TX 75119-5771 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790575 | Nextlevel Pharmaceuticals LLC | Pharmacy | 1110 Texas Pkwy, Stafford, TX 77477-6419 | 2020-11-06 |
| 1629679410 | Duehan Tran Ngo | Pharmacy | 403 W Sam Houston Pkwy N, Houston, TX 77024-4736 | 2020-11-06 |
| 1679174882 | Comanche County Medical Center Company | Pharmacy | 1870 State Hwy 36, Rising Star, TX 76471 | 2020-11-04 |
| 1629679717 | Edith Achebodt | Pharmacy | 2233 Avenue J Ste 103b, Arlington, TX 76006-5884 | 2020-11-04 |
| 1356942767 | Rxassist Pharmacy, Inc. | Pharmacy | 17020 Beaver Springs Dr Ste 8, Houston, TX 77090-2398 | 2020-11-03 |
| 1154921864 | Mbepe Health LLC | Pharmacy | 301 S 9th St Ste 121, Richmond, TX 77469-3448 | 2020-10-30 |
| 1639779366 | Mens African Investors | Pharmacy | 6355 S Peek Rd Ste 300, Katy, TX 77450-7195 | 2020-10-30 |
| 1861091977 | A Medizona Pharmacy | Pharmacy | 3700 Barker Cypress Rd, Suite 700, Houston, TX 77084 | 2020-10-20 |
| 1952900078 | Nudo Pharmacy LLC | Pharmacy | 104 Industrial Blvd Ste 201, Sugar Land, TX 77478-3174 | 2020-10-20 |
| 1194324277 | Rite Scripts Pharmacy Inc | Pharmacy | 13835 Westhollow Park Dr Apt 2805, Houston, TX 77082-1885 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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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.