Organization Active NPI

Brookshire Brothers Inc

  • Community/Retail Pharmacy
  • New Caney, TX
National Provider Identifier
1912007352
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
18333 Issued in TX
Legal business name
BROOKSHIRE BROTHERS INC
Practice address
20185 US Highway 59
69
New Caney, TX 77357-8358
Phone
(281) 689-3936
Fax
(281) 689-3912
NPI assigned
Sep 25, 2006
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 18333 TX Primary

Addresses

Primary practice location

20185 US Highway 59
69
New Caney, TX 77357-8358

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
464105MedicaidTX
2106641OtherPK

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

20185 US Highway 59
Ste 69
New Caney, TX 77357
Phone (281) 689-3936

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1912007352",
    "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": "20185 US HIGHWAY 59",
            "address_2": "69",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773578358",
            "telephone_number": "281-689-3936",
            "fax_number": "281-689-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "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": "18333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106641",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKSHIRE BROTHERS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Caney, 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.