Organization
FIRST LONE STAR PHARMACY GROUP LLC
Active
Organization
FIRST LONE STAR PHARMACY GROUP LLC
Active
Other names
GLEN ROSE DISCOUNT DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN P LIPE PHARM.D. (MANAGING PARTNER)
(214) 521-9991
Entity
Organization
Contact information
Practice address
906 NE BIG BEND TRL, GLEN ROSE, TX 76043-4909
(254) 897-2711
(254) 897-3751
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
27123
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146382
—
TX
01
—
4548876
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
09/12/2024
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