Provider Demographics
NPI:1861772485
Name:SANDY, KARL ROBERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:ROBERT
Last Name:SANDY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4803
Mailing Address - Country:US
Mailing Address - Phone:864-288-0136
Mailing Address - Fax:
Practice Address - Street 1:2607 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-4803
Practice Address - Country:US
Practice Address - Phone:864-288-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3533183500000X
SC12738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist