Brookshire Grocery Company

Organization Active NPI Community/Retail Pharmacy · Owasso, OK

NPI 1083807697 · NPPES record last updated May 1, 2025

Key facts

NPI
1083807697
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
BROOKSHIRE GROCERY COMPANY
Practice address
11550 N 135TH East Ave
Owasso, OK 74055-5739
Phone
(918) 371-6455
Fax
(918) 371-6453
NPI assigned
Aug 27, 2007
Organization subpart
No

Authorized official

Name
Neil Ducote
Title
VP Pharmacy
Phone
(903) 600-1376

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240725004696 OK Part B Supplier - Mass Immunization (Roster Biller Only) 1355415712 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sand Springs, OK; Sapulpa, OK; Tahlequah, OK; Tulsa, OK; Owasso, OK; Bixby, OK; Broken Arrow, OK; Claremore, OK…

National Provider Directory

Tax ID family
Brookshire Grocery Company (21 organizations share this tax ID)

Locations

11116 S Memorial Dr
#22
Bixby, OK 74008
Phone (918) 970-4919

3701 S Elm Pl
Broken Arrow, OK 74011
Phone (918) 455-3902

1100 E Kenosha St
Broken Arrow, OK 74012
Phone (918) 251-1295

1100 E Kenosha St
#14
Broken Arrow, OK 74012
Phone (918) 251-1295

3701 S Elm Pl
#8
Broken Arrow, OK 74011
Phone (918) 455-8102

2500 N Highway 66
Catoosa, OK 74015
Phone (918) 266-8113

2500 N Highway 66
#17
Catoosa, OK 74015
Phone (918) 266-8113

1000 W Will Rogers Blvd
Claremore, OK 74017
Phone (918) 341-4557

1000 W Will Rogers Blvd
#4
Claremore, OK 74017
Phone (918) 341-4557

446 S Elm St
#20
Jenks, OK 74037
Phone (918) 299-2684

446 S Elm St
Jenks, OK 74037
Phone (918) 299-2684

11550 N 135th East Ave
#18
Owasso, OK 74055
Phone (918) 371-6455

11815 E 86th St N
#9
Owasso, OK 74055
Phone (918) 273-3030

3925 S State Highway 97
#21
Sand Springs, OK 74063
Phone (918) 246-7207

132 W Taft Ave
#3
Sapulpa, OK 74066
Phone (918) 224-3600

2001 S Muskogee Ave
#2
Tahlequah, OK 74464
Phone (918) 456-6103

1885 S Yale Ave
#16
Tulsa, OK 74112
Phone (918) 293-2256

3915 S Peoria Ave
#25
Tulsa, OK 74105
Phone (918) 747-6756

11005 E 41st St
#13
Tulsa, OK 74146
Phone (918) 610-3245

7114 S Sheridan Rd
#7
Tulsa, OK 74133
Phone (918) 481-0000

2429 E 15th St
#19
Tulsa, OK 74104
Phone (918) 748-8350

3328 E 51st St
#23
Tulsa, OK 74135
Phone (918) 743-5782

4909 E 41st St
#15
Tulsa, OK 74135
Phone (918) 270-7060

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Yes
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

11550 N 135TH East Ave
Owasso, OK 74055-5739

Mailing address

1600 WSW Loop 323
Tyler, TX 75701-8532

Other identifiers

IdentifierTypeStateIssuer
100244350HMedicaidOK
2077140OtherPK

Other names

  • Reasor's Pharmacy #918 Doing business as

Other providers in Owasso, OK

All providers in Owasso, OK · Community/Retail Pharmacy in Oklahoma

Sources for this page

Verify at the official NPI Registry.