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General NPI Number Information
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NPI Number | 1023909082
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Entity Type | Individual
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Provider Name | SEAN KENNEDY
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Gender | Male
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 5544 PROMENADE PKWY
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City | CASTLE ROCK
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State | CO
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Zip | 80108-1903
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Country | US
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Telephone | 303-562-9131
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Fax |
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Provider Business Mailing Address
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Address Line | 5544 PROMENADE PKWY
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City | CASTLE ROCK
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State | CO
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Zip | 80108-1903
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Country | US
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Telephone | 303-562-9131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0025223
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License Number State | CO
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