Organization
BROOKSHIRE BROTHERS INC
Active
Other names
BROOKSHIRE BROTHERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ALSTON (CHIEF OPERATIONS OFFICER)
(936) 634-8155
Entity
Organization
Contact information
Practice address
1103 W 1ST ST, DERIDDER, LA 70634-3705
(337) 463-2258
(337) 462-0145
Mailing address
1103 W 1ST ST, DERIDDER, LA 70634-3705
(337) 463-2258
(337) 462-0145
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4623
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1268763
—
LA
01
—
2028933
PK
—
Enumeration date
09/22/2006
Last updated
02/06/2020
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