Brookshire Brothers Inc
Organization Active NPI Community/Retail Pharmacy · Pilot Point, TX
NPI 1114308236 · NPPES record last updated Sep 29, 2015
Key facts
- NPI
- 1114308236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 29991 (TX)
- Legal business name
- BROOKSHIRE BROTHERS INC
- Practice address
- 750 S Highway 377
Pilot Point, TX 76258-4469 - Phone
- (940) 686-5068
- Fax
- (940) 686-5085
- NPI assigned
- Jun 15, 2015
- Organization subpart
- No
Authorized official
- Name
- Lynn Russell
- Title
- Pharmacy Operations and Person
- Phone
- (936) 634-8155
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080320000508 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 0143221085 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 29991 | TX | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
750 S Highway 377
Pilot Point, TX 76258-4469
Mailing address
750 S Highway 377
Pilot Point, TX 76258-4469
Phone (940) 686-5068
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2152459 | Other | PK |
Other names
- Brookshire Brothers Pharmacy #109
Other providers in Pilot Point, TX
- Barbara Pike, M.D., P.a.
- James William Bartee
- Mary Ann Bennington
- Bott Dentistry, PLLC
- Christopher Lonnie Bott
- Shelbi Re Cates
- City of Pilot Point
- Nanette Renee Conner
- Consolidated Purchasing, LLC
- Countryside Nursing and Rehabilitation LP
All providers in Pilot Point, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.