FIRST LONE STAR PHARMACY GROUP IV LLC NPI 1174594451

NPI Information

  • NPI: 1174594451
  • Provider Name: FIRST LONE STAR PHARMACY GROUP IV LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: AXTELL PHARMACY
  • Address: 1246 S HIGHWAY 377
    STE 100
    PILOT POINT, TX
    ZIP 76258
  • Phone: (940) 686-2218

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NPI Details

FIRST LONE STAR PHARMACY GROUP IV LLC is a pharmacy in Pilot Point, TX. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. FIRST LONE STAR PHARMACY GROUP IV LLC NPI is 1174594451. The provider is registered as an organization entity type.
The provider Is Doing Business As Axtell Pharmacy.

The provider's business location address is:

1246 S HIGHWAY 377
STE 100
PILOT POINT, TX
ZIP 76258-353
Phone: (940) 686-2218
Fax: (940) 686-9286

The provider's authorized official is Mark Elliott .
The authorized official title is Operations Manager and has the following contact phone number (214) 521-9991.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 1/27/2006 and was last updated on 6/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyYes
23336C0003XPharmacyCommunity/Retail Pharmacy29669TEXASNo
33336C0004XPharmacyCompounding PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12146341OTHERPK
2141751MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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