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General NPI Number Information
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NPI Number | 1235480906
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Entity Type | Individual
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Provider Name | SEAN EMMETT O'SHEA PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 429 W PIKE ST
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City | GOSHEN
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State | IN
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Zip | 46526-2362
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Country | US
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Telephone | 574-534-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 24990 SANDY BEACH DR
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City | EDWARDSBURG
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State | MI
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Zip | 49112-9473
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Country | US
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Telephone | 847-293-9594
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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 | 5302412281
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26024474A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051295692
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License Number State | IL
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