NPIMap

Organization Active NPI

Brookshire Brothers Inc

Doing business as Brookshire Brothers Pharmacy

  • Community/Retail Pharmacy
  • Dequincy, LA
National Provider Identifier
1942309265
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3962 Issued in LA
Legal business name
BROOKSHIRE BROTHERS INC
Doing business as
Brookshire Brothers Pharmacy
Practice address
300 W 4TH St
Dequincy, LA 70633-3404
Phone
(337) 786-5863
Fax
(337) 786-5872
NPI assigned
Sep 22, 2006
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 3962 LA Primary

Addresses

Primary practice location

300 W 4TH St
Dequincy, LA 70633-3404

Mailing address

300 W 4TH St
Dequincy, LA 70633-3404
Phone (337) 786-5863

Other identifiers 2

IdentifierTypeStateIssuer
1265969MedicaidLA
2033734OtherPK

Other names 1

  • BROOKSHIRE BROTHERS PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160830002826 LA Part B Supplier - Mass Immunization (Roster Biller Only) 0143221085 2 other NPIs on this enrollment
Practice locations: Dequincy, LA; Deridder, LA; Sulphur, LA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

300 W 4th St
Dequincy, LA 70633
Phone (337) 786-5863

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": "1580947200000",
    "number": "1942309265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 4TH ST",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333404",
            "telephone_number": "337-786-5863",
            "fax_number": "337-786-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 4TH ST",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333404",
            "telephone_number": "337-786-5863",
            "fax_number": "337-786-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSHIRE BROTHERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "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": "LA",
            "license": "3962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265969",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2033734",
            "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"
        }
    ]
}

Other providers in Dequincy, LA

Sources for this page

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