Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Reasor's Pharmacy #918
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL DUCOTE (VP PHARMACY)
(903) 600-1376
Entity
Organization
Contact information
Practice address
11550 N 135TH EAST AVE, OWASSO, OK 74055-5739
(918) 371-6455
(918) 371-6453
Mailing address
1600 WSW LOOP 323, TYLER, TX 75701-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244350H
—
OK
01
—
2077140
PK
—
Enumeration date
08/27/2007
Last updated
05/01/2025
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