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Nursing Facility Supplies, Customized Equipment

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BROOKSHIRE GROCERY COMPANY

Medical Equipment Supplier Yellow Pages

Tyler, Texas

Provider NPI: 1922171495

Organization Information:
Organization Name:  BROOKSHIRE GROCERY COMPANY


Practice Location:
113 N NORTHWEST LOOP 323 ATTENTION PHARMACY DEPT TYLER, TX 75702 US
Tel: 903-593-5369  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N333600000XSuppliers
Pharmacy
TX21365
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
Y3336C0003XSuppliers
Pharmacy

Other Provider Identifiers:

IssuerNumberStateType
465110TX05
MEDICARE IMMUNIZATION BILLING-TRAILBLAZERPH0342TX01
NPI192217149501
DEABB757224801
TX DPSJ0122303TX01
TX STATE BOARD OF PHARMACY LICENSE21365TX01
OTHER ID NUMBER-COMMERCIAL NUMBER452114701
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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