Brookshire Brothers Inc
Organization Active NPI Community/Retail Pharmacy · Hearne, TX
NPI 1962501288 · NPPES record last updated Feb 5, 2020
Key facts
- NPI
- 1962501288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 18292 (TX)
- Legal business name
- BROOKSHIRE BROTHERS INC
- Practice address
- 400 W 2ND St
Hearne, TX 77859-2566 - Phone
- (979) 279-5343
- Fax
- (979) 279-3374
- NPI assigned
- Sep 22, 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
400 W 2nd St
Hearne, TX 77859
Phone (979) 279-5343
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 18292 | TX | Yes |
Addresses
Primary practice location
400 W 2ND St
Hearne, TX 77859-2566
Mailing address
1201 Ellen Trout Dr
Lufkin, TX 75904-1233
Phone (936) 634-8155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2104162 | Other | PK | |
| 464092 | Medicaid | TX |
Other names
- BROOKSHIRE BROTHERS PHARMACY
Other providers in Hearne, TX
- Amayzing Diagnostic Services Inc
- Nicholas Wayne Blackwell
- Brazos Valley Community Action Agency, Inc.
- Regina Butuk
- Cameron Calame
- Steven Marc Catalina
- Zbigniew Chmielewski
- Coryell County Memorial Hospital Authority
All providers in Hearne, 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 Feb 5, 2020. 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.