Local City Search for Medical Equipment Suppliers 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:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 333600000X | Suppliers Pharmacy | TX | 21365 |
| N | 332B00000X | Suppliers Durable Medical Equipment & Medical Supplies | ||
| Y | 3336C0003X | Suppliers Pharmacy |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 465110 | TX | 05 | |
| MEDICARE IMMUNIZATION BILLING-TRAILBLAZER | PH0342 | TX | 01 |
| NPI | 1922171495 | 01 | |
| DEA | BB7572248 | 01 | |
| TX DPS | J0122303 | TX | 01 |
| TX STATE BOARD OF PHARMACY LICENSE | 21365 | TX | 01 |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4521147 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
