Active NPI
Lori A. Backlund, R.PH.
- Pharmacist
- Lackland a F B, TX
National Provider Identifier
1255487997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4777
- Practice address
- 2200 Bergquist Dr
Lackland a F B, TX 78236-9907 - Phone
- (210) 292-5413
- Fax
- (210) 292-1216
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4777 | NM | Primary |
Addresses
Primary practice location
2200 Bergquist Dr
Lackland a F B, TX 78236-9907
Mailing address
13727 Shavano Wind
San Antonio, TX 78230-5824
Phone (214) 250-9095
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58230 | Medicaid | NM | |
| 3207215 | Other | NM | NCPDP PHARMACY ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4777 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329350400000",
"number": "1255487997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13727 SHAVANO WIND",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782305824",
"telephone_number": "214-250-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR",
"city": "LACKLAND A F B",
"state": "TX",
"postal_code": "782369907",
"telephone_number": "210-292-5413",
"fax_number": "210-292-1216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKLUND",
"first_name": "LORI",
"middle_name": "A.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2012-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "4777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58230",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PHARMACY ID",
"identifier": "3207215",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lackland a F B, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.