Provider Demographics
NPI:1760262521
Name:GROSKLAGS, SEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:GROSKLAGS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:DANUBE
Mailing Address - State:MN
Mailing Address - Zip Code:56230-0188
Mailing Address - Country:US
Mailing Address - Phone:320-522-0849
Mailing Address - Fax:
Practice Address - Street 1:1220 WESTRIDGE RD
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1000
Practice Address - Country:US
Practice Address - Phone:507-354-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist