BROOKSHIRE GROCERY COMPANY (NPI# 1710287602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710287602 |
| Entity Type | Organization |
| Organization Name | BROOKSHIRE GROCERY COMPANY |
| Other Organization Name | BROOKSHIRE PHARMACY |
| Practice Address |
1203 Us Highway 380 Bridgeport TX 76426-2087 |
| Mailing Address |
Po Box 1411 Tyler TX 75710-1411 |
| Practice Telephone | 9406831510 |
| Practice Fax Number | 9406831515 |
| Mailing Telephone | 9038776862 |
| Mailing Fax Number | 9038773820 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2012-11-01 |
| Authorized Official Name | JIM COUSINEAU (SENIOR VP OF PHRMACY OPS.) |
| Authorized Official Telephone | 9038776829 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
27158 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5901500 | 01 |
| Other Name | Type Code |
|---|---|
| BROOKSHIRE 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 |
1203 US HIGHWAY 380 |
| City | BRIDGEPORT |
| State | TX |
| Zip Code | 76426-2087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679188445 | Monica Lee Lewis | Pharmacist | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2020-09-09 |
| 1427696996 | Gary Wayne Jessup | Pharmacist | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2019-12-16 |
| 1225676141 | Brian James Richard | Pharmacist | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2019-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790169613 | Victor Esmeraldo | Dentist | 1808 Chico Hwy, Bridgeport, TX 76426 | 2015-07-10 |
| 1376941013 | K&h Dental Pa | Clinic/Center | 1808 Chico Highway, Bridgeport, TX 76426 | 2014-12-11 |
| 1710252572 | Jonathon Stanley Scarborough | Nurse Anesthetist, Certified Registered | 1509 Dr. Hospital Drive, Bridgeport, TX 76426 | 2012-03-13 |
| 1124153010 | Christopher Aaron Hicks | Physical Therapist | 707 Woodrow Wilson Ray Cir, Bridgeport, TX 76426 | 2007-02-22 |
| 1578636411 | 34hha, Inc | Home Health | 401 Center Ct., Bridgeport, TX 76426 | 2006-11-16 |
| 1295777902 | West 380 Nursing Center | Assisted Living Facility | 2108 15th St, Bridgeport, TX 76426 | 2006-06-10 |
| 1780810234 | Scc Partners Inc | Skilled Nursing Facility | 2108 15th St, Bridgeport, TX 76426 | 2009-06-10 |
| 1477175628 | Noemi Araceli Meza | Non-emergency Medical Transport (VAN) | 1006 Newby Ave, Bridgeport, TX 76426-2030 | 2020-05-11 |
| 1992013692 | Bridgeport Isd | Local Education Agency (LEA) | 2107 15th St, Bridgeport, TX 76426-2052 | 2010-09-16 |
| 1952853194 | City of Ennis | Skilled Nursing Facility | 2108 15th St, Bridgeport, TX 76426-2055 | 2016-11-03 |
| Find all providers in zip 76426 | ||||
| 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 |
|---|---|---|---|---|
| 1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
| 1609432459 | Brx LLC | Pharmacy | 319 S Virginia Ave, Bridgeport, WV 26330-1744 | 2019-05-17 |
| 1871027714 | Unity Pharmacy II LLC | Pharmacy | 679 Fairfield Ave, Bridgeport, CT 06604-3906 | 2017-04-18 |
| 1063960755 | Workers First Pharmacy Services LLC | Pharmacy | 207 W 4th St Ste B, Bridgeport, PA 19405-1012 | 2016-09-12 |
| 1265809420 | Ls Health, LLC | Pharmacy | 54 W 4th St, Suite 38, Bridgeport, PA 19405-1009 | 2015-08-24 |
| 1548673940 | Hope Dispensary of Greater Bridgeport | Pharmacy | 752 E Main St # 170, Bridgeport Dept of Health, Bridgeport, CT 06608-2335 | 2014-06-04 |
| 1538445101 | Mountaineer Medical Office Building Pharmacy | Pharmacy | 120 Medical Park Dr Ste 102, Bridgeport, WV 26330-9013 | 2011-10-27 |
| 1093094021 | Right Care Pharmacy Inc | Pharmacy | 2366 Main St, Bridgeport, CT 06606-5339 | 2011-08-09 |
| 1699879510 | Connecticut Cvs Pharmacy, L.L.C. | Pharmacy | 3710 Main St, Bridgeport, CT 06606-3613 | 2006-09-12 |
| 1225144108 | Riesbeck Food Markets, Inc. | Pharmacy | 56130 National Road, Bridgeport, OH 43912 | 2006-08-22 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 76426 |
Please comment or provide details below to improve the information on BROOKSHIRE GROCERY COMPANY.
| 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.