Organization
FIRST LONE STAR PHARMACY GROUP IV LLC
Active
Other names
EXTENDCARE PHARMACY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ELLIOT (OPERATIONS MANAGER)
(214) 521-9991
Entity
Organization
Contact information
Practice address
1246 HWY 3773, STE 200, PILOT POINT, TX 76258
(940) 686-2140
(940) 686-9286
Mailing address
1246 S HIGHWAY 377, SUITE 200, PILOT POINT, TX 76258-4353
(940) 686-2140
(940) 686-9286
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
29469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146343
PK
—
Enumeration date
08/22/2006
Last updated
10/10/2025
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