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Export Provider Record NPI 1053671842
Brookshire Grocery Company
Organization Subpart: NO
Active
NPI Number1053671842
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1053671842
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2012-05-25
Last Updated2025-04-30
Authorized OfficialNeil Ducote
VP Pharmacy
Phone: 9036001376
Mailing Address1600 Wsw Loop 323
Tyler, TX 75701-8532
United States
📍 View Map
Primary Practice Address3825 S Highway 97
Sand Springs, OK 74063-3832
United States
Phone: (918) 246-7202 | Fax: (918) 419-2434
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDOK100244350M
Other (non-Medicare)2135328PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies
No333600000X – Pharmacy
No3336C0004X – Pharmacy, Compounding Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail Pharmacy
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About NPI 1053671842

Brookshire Grocery Company is an organization registered in the CMS NPPES NPI Registry with NPI number 1053671842. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Sand Springs, OK. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-05-25. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053671842?

NPI 1053671842 belongs to Brookshire Grocery Company, a Pharmacy, Community/Retail Pharmacy in Sand Springs, OK. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053671842 active?

The current status of NPI 1053671842 in the NPPES registry is Active. The record was last updated on 2025-04-30.

What specialty is NPI 1053671842?

NPI 1053671842 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053671842?

You can verify NPI 1053671842 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053671842?

The primary practice address on file for NPI 1053671842 is 3825 S Highway 97, Sand Springs, OK 74063-3832. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053671842 issued?

NPI 1053671842 was first issued (enumerated) on 2012-05-25. The NPPES record was last updated on 2025-04-30.

Practice Location Map

Brookshire Grocery Company is located at 3825 S Highway 97, Sand Springs, OK. Use the map below to find directions or verify the practice location.

📍 3825 S Highway 97, Sand Springs, OK 74063-3832  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Brookshire Grocery Company. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-15 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162