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SUPER 1 PHARMACY
NPI 1073686309
Pharmacy - Community/Retail Pharmacy in Tyler, TX

Active since November 16, 2006
1105 E GENTRY PKWY, ATTENTION PHARMACY DEPT, TYLER, TX 75702(903) 535-9467(903) 535-9468 Get Directions Write a Review

NPPES record last updated: November 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 22, 2016, Aug 10, 2016 (2 updates tracked since 2016).

About Super 1 Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPER 1 PHARMACY (NPI 1073686309) is a healthcare organization registered as a community/retail pharmacy in Tyler, Texas and active in the NPI registry since November 2006. The organization lists Jim Cousineau, Vp Pharmacy Operations, as its authorized official.

NPPES Registry Identity

NPI1073686309
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBROOKSHIRE GROCERY COMPANY
Location Address1105 E GENTRY PKWY, ATTENTION PHARMACY DEPTTyler, TX 75702-4715
Mailing Address1600 W Sw Loop 323, Po Box 1411Tyler, TX 75701-8532 · (903) 877-6827 · Fax (903) 877-3820
Phone(903) 535-9467
Fax(903) 535-9468
Organization SubpartNo
Authorized OfficialJim CousineauVp Pharmacy Operations · (903) 877-6514
Enumeration DateNovember 16, 2006
Last NPPES UpdateNovember 22, 20162 updates tracked since enumeration
✔ NPI 1073686309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 16238
Definition
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.
Also ListedPharmacyTaxonomy 333600000X
1105 E GENTRY PKWY, Tyler, TX 75702
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Other Names 1

Doing Business AsSuper 1 Pharmacy

Other Identifiers 3

Medicare NSC1012120006
Medicaid463965TX
Other2104432Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUAN EDUARDO LOY
Pharmacist
1105 E GENTRY PKWY
TYLER, TX 75702
Smith County (903) 535-9467
HECTOR GUTIERREZ PHARM.D
Pharmacist
1105 E GENTRY PKWY
TYLER, TX 75702
Smith County (903) 535-9467
WALGREEN CO.
Pharmacy
1105 E GENTRY PKWY
TYLER, TX 75702
Smith County (903) 535-9467
JACOB WILLIAMSON PHARMD
Pharmacist
1105 E GENTRY PKWY
TYLER, TX 75702
Smith County (903) 535-9467

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brookshire Grocery Company's NPI number?

The NPI number for Brookshire Grocery Company is 1073686309. It was assigned to this organization in the NPPES registry on November 16, 2006. The provider is doing business as Super 1 Pharmacy.

Where is Brookshire Grocery Company located?

Brookshire Grocery Company is located at 1105 E Gentry Pkwy Attention Pharmacy Dept, Tyler, TX 75702. The listed phone number is (903) 535-9467.

What is Brookshire Grocery Company's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Brookshire Grocery Company accept?

Health plans from Medica and Moda Health Plan, Inc. list Brookshire Grocery Company as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brookshire Grocery Company was last updated on November 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.