# FIRST LONE STAR PHARMACY GROUP IV LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EXTENDCARE PHARMACY SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326154113
- **Authorized official:** MARK ELLIOT (OPERATIONS MANAGER)
- **Authorized official phone:** (214) 521-9991

## Contact information

- **Practice address:** 1246 HWY 3773, STE 200, PILOT POINT, TX 76258
- **Practice address phone:** (940) 686-2140
- **Practice address fax:** (940) 686-9286
- **Mailing address:** 1246 S HIGHWAY 377, SUITE 200, PILOT POINT, TX 76258-4353
- **Mailing address phone:** (940) 686-2140
- **Mailing address fax:** (940) 686-9286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 29469 | TX | Yes |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 10/10/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2146343 | PK | — |