Brookshire Brothers Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

19549 Issued in TX

Legal business name

BROOKSHIRE BROTHERS INC

Practice address

14100 Ranch Road 12
Suite 2a
Wimberley, TX 78676-5354

Phone

(512) 847-7520

Fax

(512) 842-8032

NPI assigned

Sep 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Alston

Title

Chief Operations Officer

Phone

(936) 634-8155

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BROOKSHIRE BROTHERS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1114026432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 RANCH ROAD 12",
            "address_2": "SUITE 2A",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765354",
            "telephone_number": "512-847-7520",
            "fax_number": "512-842-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 RANCH ROAD 12",
            "address_2": "SUITE 2A",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765354",
            "telephone_number": "512-847-7520",
            "fax_number": "512-842-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "936-634-8155"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "19549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2092113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRE BROTHERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Debra J Burke, AU.D.
• Michael Lawrence Buse, DPT
• Michelle Marie Buse, L.AC.
• James Francis Byrne, CRNA

• Community/Retail Pharmacy in Wimberley, TX
• Providers in Wimberley, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.