Brookshires Pharmacy #122

LBN: Brookshire Grocery Company
Brookshires Pharmacy #122 is an health care organization with primary practice located at 2861 Terry Rd Attention Pharmacy Dept, Jackson MS 39212-3051. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Brookshire Grocery Company can be contacted via phone (601) 372-2387, or through Cousineau, Jim D via phone (903) 877-6829.

Contact Information

Primary practice address
2861 Terry Rd Attention Pharmacy Dept Jackson MS 39212-3051
Phone: (601) 372-2387
Fax: (601) 372-0369
Website:
Map and Directions
Authorized official contact:
Name: Cousineau, Jim D RPH
Phone: (903) 877-6829

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 03698 / 01.2 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1205909777
LBN Legal business name Brookshire Grocery Company
DBA Doing business as Brookshires Pharmacy #122
Authorized official Cousineau, Jim D RPH
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2006
Last updated Feb 27th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205909777 NPPES
Mississippi MEDICAID 0330683
Mississippi Other 2521119

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