Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
BROOKSHIRES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL DUCOTE (VP PHARMACY)
(903) 600-1376
Entity
Organization
Contact information
Practice address
105 E OVILLA RD, RED OAK, TX 75154-2490
(972) 617-8570
(972) 617-8571
Mailing address
1600 WSW LOOP 323, TYLER, TX 75701-8532
(903) 877-6870
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
19364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2091471
PK
—
05
—
464272
—
TX
Enumeration date
11/16/2006
Last updated
02/14/2023
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