Provider Demographics
NPI:1871733626
Name:JOHNSTON, SEAN JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:JAMES
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CAPEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-2304
Mailing Address - Country:US
Mailing Address - Phone:860-274-6979
Mailing Address - Fax:860-274-6947
Practice Address - Street 1:138 CAPEWELL AVE
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06779-2304
Practice Address - Country:US
Practice Address - Phone:860-274-6979
Practice Address - Fax:860-274-6947
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT08182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist