Provider Demographics
NPI:1124635842
Name:SANDO, ROBERT BRUCE (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:SANDO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OAK DR
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5137
Mailing Address - Country:US
Mailing Address - Phone:410-303-6866
Mailing Address - Fax:410-744-0241
Practice Address - Street 1:101 OAK DR
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5137
Practice Address - Country:US
Practice Address - Phone:410-303-6866
Practice Address - Fax:410-744-0241
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty