Healthcare Provider Details

I. General information

NPI: 1316280530
Provider Name (Legal Business Name): SEAN CHARLES STODGELL PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 N UNION BLVD
COLORADO SPRINGS CO
80920-7826
US

IV. Provider business mailing address

9225 N UNION BLVD
COLORADO SPRINGS CO
80920-7826
US

V. Phone/Fax

Practice location:
  • Phone: 719-522-2201
  • Fax: 719-522-2204
Mailing address:
  • Phone: 719-522-2203
  • Fax: 719-522-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number16188
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: