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General NPI Number Information
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NPI Number | 1811538242
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Entity Type | Organization
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Legal Business Name | BROOKSHIRE DISCOUNT PHARMACY LLC
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 5001 FRONT ST STE 9
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City | BROOKSHIRE
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State | TX
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Zip | 77423-8503
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Country | US
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Telephone | 281-375-9673
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Fax |
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Provider Business Mailing Address
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Address Line | 5001 FRONT ST STE 9
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City | BROOKSHIRE
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State | TX
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Zip | 77423-8503
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Country | US
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Telephone | 281-375-9673
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MS. APRIL D KEMPER
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Credential |
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Telephone | 281-375-9672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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