Provider Demographics
NPI:1891556858
Name:BROOKER LLC
Entity Type:Organization
Organization Name:BROOKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEMONTRAE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-786-8089
Mailing Address - Street 1:3658 ALTA LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-2185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3658 ALTA LAKES BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32226-2185
Practice Address - Country:US
Practice Address - Phone:832-786-8089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies