Brookshire Brothers Inc

Organization Active NPI Community/Retail Pharmacy · Onalaska, TX

NPI 1205935525 · NPPES record last updated Feb 5, 2020

Key facts

NPI
1205935525
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
19550 (TX)
Legal business name
BROOKSHIRE BROTHERS INC
Practice address
14981 Old Trinity Rd
Onalaska, TX 77360
Phone
(936) 646-2488
Fax
(936) 646-2476
NPI assigned
Sep 22, 2006
Organization subpart
No

Authorized official

Name
John Alston
Title
Chief Operation Officer
Phone
(936) 634-8155

Practitioners 3

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 TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 19550 TX Yes

Addresses

Primary practice location

14981 Old Trinity Rd
Onalaska, TX 77360

Mailing address

1201 Ellen Trout Dr
Lufkin, TX 75904-1233
Phone (936) 634-8155

Other identifiers

IdentifierTypeStateIssuer
464303MedicaidTX
2092112OtherPK

Other names

  • BROOKSHIRE BROTHERS PHARMACY Doing business as

Other providers in Onalaska, TX

All providers in Onalaska, TX · Community/Retail Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.