Organization
BROOKSHIRE BROTHERS INC
Active
Other names
Brookshire Brothers Pharmacy #79
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ALSTON (PRESIDENT CEO)
(936) 634-8155
Entity
Organization
Contact information
Practice address
18275 FM 306, CANYON LAKE, TX 78133
(830) 935-3136
(830) 935-3138
Mailing address
1201 ELLEN TROUT DR, LUFKIN, TX 75904-1233
(936) 634-8155
(936) 633-4678
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30252
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154777
PK
—
05
—
468309
—
TX
Enumeration date
10/23/2015
Last updated
11/19/2020
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