Organization
BROOKSHIRE BROTHERS LTD
Active
Other names
BROOKSHIRE BROTHERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAYBURN MITCHUM BS (PHARMACY ADMINISTRATOR)
(936) 634-8155
Entity
Organization
Contact information
Practice address
1807 W FRANK AVE, SUITE B, LUFKIN, TX 75904-3185
(936) 634-3285
(936) 634-8218
Mailing address
1807 W FRANK AVE, SUITE B, LUFKIN, TX 75904-3185
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
21990
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350177
—
TX
01
—
4525260
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/25/2006
Last updated
07/19/2007
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