Organization Active NPI

Brookshire Brothers Inc

  • Community/Retail Pharmacy
  • Cuero, TX
National Provider Identifier
1558029108
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BROOKSHIRE BROTHERS INC
Practice address
1161 N Esplanade St
Cuero, TX 77954-3433
Phone
(361) 524-4000
Fax
(361) 275-8285
NPI assigned
Dec 1, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tonia Lynn Adkison
Title
Pharmacy Admin
Phone
(936) 634-8155

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
Tax ID family
Brookshire Brothers Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1161 N Esplanade St
Cuero, TX 77954
Phone (361) 524-4000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

NPPES NPI Registry

Primary practice location

1161 N Esplanade St
Cuero, TX 77954-3433

Mailing address

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
34065OtherTXTSBP

Other names 1

NPPES NPI Registry
  • Brookshire Brothers Pharmacy #91 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2021.

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1558029108",
    "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": "1161 N ESPLANADE ST",
            "city": "CUERO",
            "state": "TX",
            "postal_code": "779543433",
            "telephone_number": "361-524-4000",
            "fax_number": "361-275-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "ADKISON",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACY ADMIN",
        "authorized_official_telephone_number": "936-634-8155"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBP",
            "identifier": "34065",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookshire Brothers Pharmacy #91",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cuero, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.