Provider Demographics
NPI:1821260282
Name:GUNDLER, SANDRA (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:GUNDLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7796
Mailing Address - Country:US
Mailing Address - Phone:740-964-5186
Mailing Address - Fax:740-964-9007
Practice Address - Street 1:325 W BROAD ST
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8136
Practice Address - Country:US
Practice Address - Phone:740-964-1007
Practice Address - Fax:740-964-9007
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist