Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Reasor's Pharmacy #925
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL DUCOTE (VP PHARMACY)
(903) 600-1376
Entity
Organization
Contact information
Practice address
3915 S PEORIA AVE, TULSA, OK 74105-3130
(918) 747-9740
(918) 744-8106
Mailing address
1600 WSW LOOP 323, TYLER, TX 75701-8532
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114270T
—
OK
01
—
2142013
PK
—
Enumeration date
06/04/2006
Last updated
05/01/2025
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