Provider Demographics
NPI:1437533478
Name:SUDERS, RANDALL DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:DOUGLAS
Last Name:SUDERS
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 1:520 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4223
Mailing Address - Country:US
Mailing Address - Phone:804-225-1340
Mailing Address - Fax:804-225-8072
Practice Address - Street 1:520 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4223
Practice Address - Country:US
Practice Address - Phone:804-225-1340
Practice Address - Fax:804-225-8072
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist