Brookshire Brothers Inc
Organization Active NPI Community/Retail Pharmacy · Coldspring, TX
NPI 1962439919 · NPPES record last updated Aug 6, 2015
Key facts
- NPI
- 1962439919
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 25661 (TX)
- Legal business name
- BROOKSHIRE BROTHERS INC
- Practice address
- 15100 Hwy 150 W
Coldspring, TX 77331 - Phone
- (936) 653-3284
- Fax
- (936) 653-3286
- NPI assigned
- Jun 26, 2006
- Organization subpart
- No
Authorized official
- Name
- John Alston
- Title
- Chief Operations Officer
- Phone
- (936) 634-8155
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080320000508 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 0143221085 | This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
15100 State Highway 150 W
Coldspring, TX 77331
Phone (936) 653-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 25661 | TX | Yes |
Addresses
Primary practice location
15100 Hwy 150 W
Coldspring, TX 77331
Mailing address
1201 Ellen Trout Dr
Lufkin, TX 75904-1233
Phone (936) 634-8155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2096659 | Other | PK | |
| 466411 | Medicaid | TX |
Other names
- BROOKSHIRE BROTHERS PHARMACY
Other providers in Coldspring, TX
- A&S Support Services, Inc
- Jeffery Hugh Anderson
- Elizabeth Becerra
- Brookshire Brothers Inc
- Jeffrey C. Brown
- Coldspring-Oakhurst Cisd
- Coldsprings Pharmacy
- Hillary Dianne Collins
- Sara Crawford
All providers in Coldspring, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.