Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
REASORS PHARMACY, Reasor's Pharmacy #902
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL DUCOTE (VP PHARMACY)
(903) 600-1376
Entity
Organization
Contact information
Practice address
2001 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5454
(918) 456-6103
(918) 456-6118
Mailing address
1600 WSW LOOP 323, TYLER, TX 75701-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
36-5429
OK
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100244350A
—
OK
01
—
2073355
PK
—
Enumeration date
11/27/2006
Last updated
04/30/2025
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