Organization Active NPI

Brookshire Brothers Inc

Doing business as Brookshire Brothers Pharmacy

  • Community/Retail Pharmacy
  • Nacogdoches, TX
National Provider Identifier
1225137540
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
18317 Issued in TX
Legal business name
BROOKSHIRE BROTHERS INC
Doing business as
Brookshire Brothers Pharmacy
Practice address
1420 N University Dr
Nacogdoches, TX 75961-4221
Phone
(936) 564-0800
Fax
(936) 564-0700
NPI assigned
Sep 22, 2006
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 18317 TX Primary

Addresses

Primary practice location

1420 N University Dr
Nacogdoches, TX 75961-4221

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
464106MedicaidTX
2105421OtherPK

Other names 1

  • BROOKSHIRE BROTHERS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

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

National Provider Directory

Locations

1420 N University Dr
Nacogdoches, TX 75961
Phone (936) 564-0800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1225137540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ELLEN TROUT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759041233",
            "telephone_number": "936-634-8155",
            "fax_number": "936-634-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614221",
            "telephone_number": "936-564-0800",
            "fax_number": "936-564-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-08-06",
        "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": "18317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464106",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2105421",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRE BROTHERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.