MEDICARE: SEAN DONAHOE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	119257	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	119257	OTHER	MN	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1831606755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN DONAHOE PHARMD

Provider Business Mailing Address
First Line	:	2015 S BROADWAY ST
Second Line	:
City	:	NEW ULM
State	:	MN
Zip	:	56073-3954
Country	:	US
Telephone Number	:	507-354-9833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 S BROADWAY ST
Second Line	:
City	:	NEW ULM
State	:	MN
Zip	:	56073-3954
Country	:	US
Telephone Number	:	507-354-9833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2017
Last Update Date	:	12/30/2017

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Directions to “ SEAN DONAHOE PHARMD” Practice Location

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