Healthcare Provider Details

I. General information

NPI: 1588266811
Provider Name (Legal Business Name): SEAN CHRISTIAN KARPOWICH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 14TH ST NE
EAST GRAND FORKS MN
56721-1628
US

IV. Provider business mailing address

224 14TH ST NE
EAST GRAND FORKS MN
56721-1628
US

V. Phone/Fax

Practice location:
  • Phone: 218-773-0611
  • Fax: 218-773-3532
Mailing address:
  • Phone: 218-773-0611
  • Fax: 218-773-3532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number120891
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: