Organization
BROOKSHIRE BROTHERS INC
Active
Other names
Brookshire Brothers Pharmacy #84
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN RUSSELL (PHARMACY OPERATIONS AND PERSON)
(936) 634-8155
Entity
Organization
Contact information
Practice address
1004 E MAIN ST, HAMILTON, TX 76531-1572
(254) 386-3682
(254) 386-3687
Mailing address
1004 E MAIN ST, HAMILTON, TX 76531-1572
(254) 386-3682
(254) 386-3687
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29990
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152454
PK
—
Enumeration date
06/15/2015
Last updated
09/29/2015
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