MEDICARE: LLOYD CARL SARBACKER PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	19645	NC
2	1835P1200X	Pharmacotherapy Pharmacist	19645	NC

General Provider Information

NPI Number	:	1982941662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LLOYD CARL SARBACKER PHARM.D.

Provider Business Mailing Address
First Line	:	1513 BACCARAT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4434
Country	:	US
Telephone Number	:	704-989-1659
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 BACCARAT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4434
Country	:	US
Telephone Number	:	704-989-1659
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/15/2013

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