Brookshire Brothers Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

19434 Issued in TX

Legal business name

BROOKSHIRE BROTHERS INC

Practice address

1220 W Commerce
Buffalo, TX 75831

Phone

(903) 322-1315

Fax

(903) 322-4336

NPI assigned

Sep 25, 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

Practitioners 1

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

• Brittany Melissa Lyon

  • Pharmacist
  • Buffalo, TX
  • NPI 1821689530
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1467552802",
    "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": "936-633-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W COMMERCE",
            "city": "BUFFALO",
            "state": "TX",
            "postal_code": "75831",
            "telephone_number": "903-322-1315",
            "fax_number": "903-322-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "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": "19434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464291",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2091880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRE BROTHERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BROOKSHIRE BROTHERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Buffalo, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.