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Organization
BROOKSTAN PHARMACY LLC
Active
Organization
BROOKSTAN PHARMACY LLC
Active
Parent organization
BROOKSTAN PHARMACY, LLC
Other names
Medical Square Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROOKSTAN PHARMACY, LLC
Authorized official
BROOKE M MCLEAN (MEMBER/OWNER)
(806) 350-7451
Entity
Organization
Contact information
Practice address
1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
(806) 350-7451
(806) 350-7454
Mailing address
1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
(806) 350-7451
(806) 350-7454
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148774
—
TX
Enumeration date
10/04/2021
Last updated
10/04/2021
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