# BROOKSTAN PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BROOKSTAN PHARMACY, LLC
- **Other names:** Medical Square Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699447037
- **Legal business name:** BROOKSTAN PHARMACY, LLC
- **Authorized official:** BROOKE M MCLEAN (MEMBER/OWNER)
- **Authorized official phone:** (806) 350-7451

## Contact information

- **Practice address:** 1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
- **Practice address phone:** (806) 350-7451
- **Practice address fax:** (806) 350-7454
- **Mailing address:** 1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
- **Mailing address phone:** (806) 350-7451
- **Mailing address fax:** (806) 350-7454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/04/2021
- **Last updated:** 10/04/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 148774 | — | TX |