Organization
BROOKSTAN PHARMACY LLC
Active
Other names
Medical Square Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE MCLEAN (CO-OWNER, PIC)
(806) 350-7451
Entity
Organization
Contact information
Practice address
1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
(806) 350-7451
(806) 350-7454
Mailing address
1215 S COULTER ST STE 101, AMARILLO, TX 79106-1761
(806) 350-7451
(806) 350-7454
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29520
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147014
—
TX
01
—
2147909
PK
—
Enumeration date
02/27/2014
Last updated
05/28/2021
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