Super 1 Foods Pharmacy
LBN: Brookshire Grocery Company
Super 1 Foods Pharmacy is an health care organization with primary practice located at 5805 Dollarway Rd Attention Pharmacy Dept, Pine Bluff AR 71602-3824. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Brookshire Grocery Company can be contacted via phone (870) 247-5854, or through Cousineau, Jim via phone (903) 877-6514.
Contact Information
Primary practice address
5805 Dollarway Rd Attention Pharmacy Dept
Pine Bluff AR 71602-3824
Phone: (870) 247-5854
Fax: (870) 247-1782
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 0420005 | Arkansas |
Profile Details
| NPI number | 1326111899 |
|---|---|
| LBN Legal business name | Brookshire Grocery Company |
| DBA Doing business as | Super 1 Foods Pharmacy |
| Authorized official | Cousineau, Jim RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Jul 19th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326111899 | NPPES |
| Other | 1988192 | PK | |
| MEDICAID | 130899407 | PK |
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