BROOKSHIRE GROCERY COMPANY (NPI# 1598838062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598838062 |
| Entity Type | Organization |
| Organization Name | BROOKSHIRE GROCERY COMPANY |
| Other Organization Name | SUPER 1 PHARMACY |
| Practice Address |
1500 N Trenton St Attention Pharmacy Dept Ruston LA 71270-2328 |
| Mailing Address |
1600 W Sw Loop 323 Po Box 1411 Tyler TX 75701-8532 |
| Practice Telephone | 3182548256 |
| Practice Fax Number | 3182548270 |
| 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 |
932961 | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2033207 | 01 | |
| LA | 1261912 | 05 |
| Other Name | Type Code |
|---|---|
| SUPER 1 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 |
1500 N TRENTON ST ATTENTION PHARMACY DEPT |
| City | RUSTON |
| State | LA |
| Zip Code | 71270-2328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497209829 | Robert Marcus Black | Pharmacist | 1500 N Trenton St, Ruston, LA 71270-2328 | 2016-08-15 |
| 1972955516 | Karen Kendrick | Pharmacist | 1500 N Trenton St, Ruston, LA 71270-2328 | 2016-07-07 |
| 1396004909 | Juli Rebekah Larry | Pharmacist | 1500 N Trenton St, Ruston, LA 71270-2328 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1255808085 | Amanda M Clark | Specialist/Technologist | 2301 Timberline Ct Apt F105, Ruston, LA 71270 | 2018-10-30 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| Find all providers in zip 71270 | ||||
| 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 |
|---|---|---|---|---|
| 1144471848 | Mitchell's Compounding Pharmacy | Pharmacy | 109 N Trenton St, #2, Ruston, LA 71270-4321 | 2008-10-01 |
| 1023156395 | Waltz & Brazzel Pharmacy Inc | Pharmacy | 200 North Trenton Street, Ruston, LA 71270 | 2007-02-01 |
| 1336228931 | Prescription Shoppe, LLC | Pharmacy | 104 W Line Ave, Ruston, LA 71270-5044 | 2006-11-03 |
| 1033738240 | Winn Community Health Center, Inc. | Pharmacy | 1140 S Vienna St, Ruston, LA 71270-5834 | 2020-04-09 |
| 1992064505 | Miller Pharmacy Services LLC | Pharmacy | 104 W Line Ave, Ruston, LA 71270-5044 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568054 | Chris Pharmacy of Gonzalez LLC | Pharmacy | 14505 Highway 44 Ste 112, Gonzales, LA 70737-7195 | 2020-11-02 |
| 1639779788 | Harvey Lee Smith Jr. | Pharmacy | 1707 Gardere Ln Ste F, Baton Rouge, LA 70820-8144 | 2020-10-28 |
| 1194331579 | Minden Family Pharmacy LLC | Pharmacy | 120 Homer Rd, Minden, LA 71055 | 2020-09-21 |
| 1093321812 | Community Pharmacy of Sterlington | Pharmacy | 200 Scott Dr, Sterlington, LA 71280 | 2020-09-17 |
| 1386256121 | Lagniappe Pharmacy 7, LLC | Pharmacy | 1900 Saint Charles Ave, New Orleans, LA 70130-5317 | 2020-08-22 |
| 1740890144 | Downtown Drugs Inc | Pharmacy | 338 N Vermont St, Covington, LA 70433-2812 | 2020-07-31 |
| 1053929703 | Viallon Drug Co of Donaldsonville | Pharmacy | 309 Marchand Dr, Donaldsonville, LA 70346-3242 | 2020-07-20 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1417573593 | Doc Your Dose Pharmacy, LLC | Pharmacy | 17275 Hwy 77, Gross Tete, LA 70740 | 2020-06-24 |
| 1942829247 | Good Vibe Ventures LLC | Pharmacy | 5004 W Esplanade Ave Ste A, Metairie, LA 70006-2551 | 2020-04-16 |
| 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.