Healthcare Provider Details

I. General information

NPI: 1558461996
Provider Name (Legal Business Name): BROOKSHIRE BROTHERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N FRONTAGE RD
LORENA TX
76655-3812
US

IV. Provider business mailing address

1201 ELLEN TROUT DR
LUFKIN TX
75904-1233
US

V. Phone/Fax

Practice location:
  • Phone: 254-857-3955
  • Fax: 254-857-4997
Mailing address:
  • Phone: 936-634-8155
  • Fax: 936-633-4678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number19337
License Number StateTX

VIII. Authorized Official

Name: JOHN ALSTON
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 936-634-8155