BROOKSHIRES PHARMACY
NPI 1275606501
Pharmacy - Community/Retail Pharmacy in Van, TX

NPI Status: Active since November 16, 2006

Contact Information

706 WEST MAIN
ATTENTION PHARMACY DEPT
VAN, TX
ZIP 75790
Phone: (903) 963-3834
Fax: (903) 963-3534

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance
  • CLIA Number: 45D2090566
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 01-26-2027

About BROOKSHIRES PHARMACY

This page provides the complete NPI Profile along with additional information for Brookshires Pharmacy, a provider established in Van, Texas operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1275606501 assigned on November 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 20993 (TX). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Brookshires Pharmacy. The authorized official of this NPI record is Jim Cousineau Rph (Vp Pharmacy Operations)

NPI
1275606501
Provider Legal Name
BROOKSHIRE GROCERY COMPANY
Other Organization Name
BROOKSHIRES PHARMACY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
706 WEST MAIN ATTENTION PHARMACY DEPT VAN, TX 75790
Location Phone
(903) 963-3834
Location Fax
(903) 963-3534
Mailing Address
PO BOX 1219 ATTENTION PHARMACY DEPT VAN, TX 75790
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-16-2006
Last Update Date
08-19-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
20993
License State
TX
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1333600000XSuppliers

Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Max 70/50 $6700 - PPO
  • Blue Max 90/70 $1500 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $3300 - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan - PPO
  • Blue Max Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan - PPO
  • Blue Saver 60/40 $6100 - PPO
  • Blue Saver 90/70 $3200 - PPO
  • Blue Connect 80/60 $3200 (L) - POS
  • Blue Connect 80/60 $3200 (N) - POS
  • Blue Connect 80/60 $3200 (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (L) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (N) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 50/50 $7500 Standardized Plan (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (L) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (N) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 60/40 $5000 Standardized Plan (S) - POS
  • Blue Connect Copay (PCP, Specialist, Urgent Care) 75/55 $1500 Standardized Plan (L) - POS
  • Balance by Medica Bronze $0 Copay PCP Visits - EPO
  • Balance by Medica Bronze $0 Copay PCP Visits - PPO
  • Balance by Medica Bronze Premier - EPO
  • Balance by Medica Bronze Premier - PPO
  • Balance by Medica Catastrophic - EPO
  • Balance by Medica Catastrophic - PPO
  • Balance by Medica Expanded Bronze Standard - EPO
  • Balance by Medica Expanded Bronze Standard - PPO
  • Balance by Medica Gold $0 Copay PCP Visits - EPO
  • Balance by Medica Gold $0 Copay PCP Visits - PPO
  • Moda Health Affinity Bronze 7750 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Essential Bronze 6500 - POS
  • Essential Gold 1500 - POS
  • Freedom Silver 4000 - POS
  • Savings Bronze 7700 - POS
  • Standard Bronze 7500 - POS
  • Standard Gold 1500 - POS
  • Standard Silver 5000 - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JIM COUSINEAU RPH

Authorized Official Title
VP PHARMACY OPERATIONS
Authorized Official Phone
(903) 877-6514

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1012120086MEDICARE NSC (07) 
2095837OTHER (01)PK
464885MEDICAID (05)TX 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 50mcg/0.25mlbst

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.

This service was performed 68 times for 66 patients

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 12 times for 12 patients

Administration of influenza virus vaccine

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.

This service was performed 129 times for 129 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 13 times for 13 patients

Fee covid-19 vac 14 res

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.

This service was performed 18 times for 18 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 94 times for 94 patients

Influenza vaccine, quadrivalent derived from recombinant dna

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.

This service was performed 33 times for 33 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2090566
Facility Type
Pharmacy
Certificate Effective Date
January 27, 2025
Certificate Expiration Date
January 26, 2027
Laboratory Director
CLARISSA B. REYES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Brookshires Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1275606501
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221451201250
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 4 + 5 + 1 + 2 + 0 + 1 + 2 + 5 + 0 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1275606501 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275606501, enumerated in the NPI registry as an "organization" on November 16, 2006

The provider is located at 706 West Main Attention Pharmacy Dept Van, Tx 75790 and the phone number is (903) 963-3834

This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy

The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, HMO. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The most common procedures or services performed by this practitioner are: Adm sarscov2 50mcg/0.25mlbst, Adm sarscv2 30mcg trs-sucr b, Administration of influenza virus vaccine, Fee covid-19 vac 13 res, Fee covid-19 vac 14 res, Influenza vaccine split virus, preservative free and Influenza vaccine, quadrivalent derived from recombinant dna.

The provider's CLIA number is 45D2090566 for a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on November 16, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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