Organization
BROOKSHIRE GROCERY COMPANY
Active
Other names
Reasor's Pharmacy #909
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL DUCOTE (VP PHARMACY)
(903) 600-1376
Entity
Organization
Contact information
Practice address
11815 E 86TH ST N, OWASSO, OK 74055-2536
(918) 272-3030
(918) 272-5353
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
—
100246410A
—
OK
01
—
2081528
PK
—
Enumeration date
11/27/2006
Last updated
05/01/2025
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