Sean Patrick Kidwell, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PR5758 Issued in ME

Practice address

383 Wilson Street
Pharmacy Department
Brewer, ME 04412

Phone

(207) 989-8290

Fax

(207) 989-8293

NPI assigned

Dec 3, 2020

Last updated

Dec 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hannaford Bros Co LLC

  dba Hannaford Food and Drug

  • Community/Retail Pharmacy
  • Brewer, ME
  • NPI 1457469843
  NPD (past)
• Hannaford Bros. Co., LLC

  dba Hannaford Supermarket & Pharmacy

  • Community/Retail Pharmacy
  • Scarborough, ME
  • NPI 1861175622
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1225633662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 WILSON STREET",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-989-8290",
            "fax_number": "207-989-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 WILSON STREET",
            "address_2": "PHARMACY DEPARTMENT",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-989-8290",
            "fax_number": "207-989-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Kasap-Gomes, PTA
• Taylor Forrest Kelley, LCPC
• Patricia Ann Kenaley, FNP
• Emily Ketch, OD
• Lisa M Keyser, CLINICAL SOCIAL WORK
• Kathy Jo King, LMT
• Danielle M Kissinger, DPT
• Kathleen Anne Knipscher, DO
• Mitchell Deanna Kohls
• Julie Reva Kominsky

• Pharmacist in Brewer, ME
• Providers in Brewer, ME by specialty
• Pharmacist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.