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Individual
RANDOLPH M. GORDER
Active
Individual
RANDOLPH M. GORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8167
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4042
SD PHARMACY LICENSE #
SD
01
—
8167
AZ PHARMACY LICENSE
AZ
Enumeration date
10/31/2010
Last updated
11/01/2010
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