Healthcare Provider Details

I. General information

NPI: 1861772485
Provider Name (Legal Business Name): KARL ROBERT SANDY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 CANAL ST STE 3
BRATTLEBORO VT
05301-3421
US

IV. Provider business mailing address

104 CROSS ST
KEENE NH
03431-3013
US

V. Phone/Fax

Practice location:
  • Phone: 803-257-4204
  • Fax: 802-257-4204
Mailing address:
  • Phone: 802-257-4204
  • Fax: 802-257-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number033.0135746
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3533
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: