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Organization
BROOKSHIRE BROTHERS INC
Active
Organization
BROOKSHIRE BROTHERS INC
Active
Other names
BROOKSHIRE BROTHERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ALSTON (CHIEF OPERATIONS OFFICER)
(936) 634-8155
Entity
Organization
Contact information
Practice address
1103 W 1ST ST, DERIDDER, LA 70634-3705
(337) 463-2258
(337) 462-0145
Mailing address
1103 W 1ST ST, DERIDDER, LA 70634-3705
(337) 463-2258
(337) 462-0145
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
4623
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1268763
—
LA
01
—
2028933
PK
—
Enumeration date
09/22/2006
Last updated
02/06/2020
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