Provider Demographics
NPI:1710148655
Name:CARL, SANDRA LYNN (PHARM D)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LYNN
Last Name:CARL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-0553
Mailing Address - Country:US
Mailing Address - Phone:410-343-0110
Mailing Address - Fax:410-343-1578
Practice Address - Street 1:111 MOUNT CARMEL RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9706
Practice Address - Country:US
Practice Address - Phone:410-343-0110
Practice Address - Fax:410-343-1578
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist