NPI | 1396818860 |
---|---|
Doing Business As | BROOKSHIRES PHARMACY #121 |
Entity Type | Organization |
Authorized Contact | JIM D COUSINEAU VP Pharmacy Operations 903-877-6829 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 333600000X Pharmacy (Licence: MS 05104 / 01.2) |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2006-11-15 |
Last Update Date | 2008-02-27 |