Organization
FIRST LONE STAR PHARMACY GROUP III LLC
Active
Other names
JOSHUA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LIPE (MANAGING PARTNER)
(214) 521-9991
Entity
Organization
Contact information
Practice address
504 N BROADWAY ST, JOSHUA, TX 76058-3414
(817) 295-8531
(817) 295-3836
Mailing address
6901 PRESTON RD, DALLAS, TX 75205-1136
(214) 521-9991
(214) 521-1649
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143729
—
TX
01
—
2138449
PK
—
Enumeration date
02/06/2007
Last updated
03/07/2017
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