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SUPER 1 PHARMACY
NPI 1306919873
Pharmacy - Community/Retail Pharmacy in Bastrop, LA

Active since November 15, 2006
2211 E MADISON AVE, ATTENTION PHARMACY DEPT, BASTROP, LA 71220(318) 281-3284(318) 281-4408 Get Directions Write a Review

NPPES record last updated: December 22, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Super 1 Pharmacy NPPES

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

SUPER 1 PHARMACY (NPI 1306919873) is a healthcare organization registered as a community/retail pharmacy in Bastrop, Louisiana and active in the NPI registry since November 2006. The organization lists Jim Cousineau, Vp Pharmacy Operations, as its authorized official.

NPPES Registry Identity

NPI1306919873
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBROOKSHIRE GROCERY COMPANY
Location Address2211 E MADISON AVE, ATTENTION PHARMACY DEPTBastrop, LA 71220-4072
Mailing Address1600 W Sw Loop 323, Po Box 1411Tyler, TX 75701-8532 · (903) 877-6827 · Fax (903) 877-3820
Phone(318) 281-3284
Fax(318) 281-4408
Organization SubpartNo
Authorized OfficialJim CousineauVp Pharmacy Operations · (903) 877-6514
Enumeration DateNovember 15, 2006
Last NPPES UpdateDecember 22, 2015
✔ NPI 1306919873 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 LA · 3750
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
2211 E MADISON AVE, Bastrop, LA 71220
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Other Names 1

Doing Business AsSuper 1 Pharmacy

Other Identifiers 3

Other2033640Pk
Medicaid1264539LA
Medicare NSC1012120067

Accepted Insurance

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D2183294

Walgreens #21533 · Bastrop, LA
Expired · May 3, 2026
CLIA Number19D2183294
Laboratory TypePharmacy
Certificate Effective DateMay 4, 2024
Certificate Expiration DateMay 3, 2026
Laboratory DirectorBraxton Crawford
Laboratory Phone(318) 281-3284
Laboratory LocationWalgreens #215332211 E Madison Ave Suite A, Bastrop, LA 71220
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization dataset. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
282 services281 patients
Adm sarscov2 50mcg/0.25mlbst 0064A
This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.
199 services193 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
192 services192 patients
Fee covid-19 vac 14 res 0134A
The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.
173 services173 patients
Influenza vaccine, quadrivalent derived from recombinant dna 90682
The quadrivalent influenza vaccine, made through recombinant DNA technology, is a flu shot that protects against four different flu viruses. This vaccine is produced by genetically modifying a virus, making it safer and more effective. It's a key tool in preventing flu-related illnesses.
81 services80 patients
Adm sarscov2 100mcg/0.5ml3rd 0013A
This is the administration of a third dose of a SARS-CoV-2 vaccine, given in a dose of 100 micrograms in 0.5 milliliters. This vaccine helps your body develop immunity against the COVID-19 virus. It's a crucial step in protecting your health.
68 services68 patients

Other Providers at the Same Location NPPES 3

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

RANDAL J HANKS SR. RPH
Pharmacist
2211 E MADISON AVE
BASTROP, LA 71220
Morehouse Parish (318) 281-3284
KIMBERLY N CRNKOVIC P.D.
Pharmacist
2211 E MADISON AVE
BASTROP, LA 71220
Morehouse Parish (318) 281-3284
WALGREEN CO.
Pharmacy
2211 E MADISON AVE
BASTROP, LA 71220
Morehouse Parish (318) 281-3284

Frequently Asked Questions

What is BROOKSHIRE GROCERY COMPANY's NPI number?

The NPI number assigned to this healthcare provider is 1306919873, enumerated as an "organization" on November 15, 2006.

Where is the provider located?

The provider is located at 2211 E MADISON AVE ATTENTION PHARMACY DEPT BASTROP, LA 71220 and the phone number is (318) 281-3284.

What is the provider's specialty?

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

What insurance does BROOKSHIRE GROCERY COMPANY accept?

The provider might be accepting Accepts: Medica, Moda Health Plan, Inc., Medicare and. Please consult your insurance carrier or call the provider to verify.