Shan-Pham Diversified Holdings, Inc

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

Legal business name

SHAN-PHAM DIVERSIFIED HOLDINGS, INC

Practice address

12946 Dairy Ashford Rd Ste 450
Sugar Land, TX 77478-4643

Phone

(346) 279-0497

Fax

(346) 279-0498

NPI assigned

Apr 16, 2021

Organization subpart

No

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

Authorized official

Name

Sejal Shan

Title

Officer

Phone

(281) 203-7829

Specialties & licenses 1

Addresses

Other names 1

• MEDhope Pharmacy Doing business as

Tax ID family

Medhope Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shan-Pham Diversified Holdings, Inc

  • Community/Retail Pharmacy
  • Sugar Land, TX
  • NPI 1326501115
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monica Ann Kuruvilla, PHARMD

  • Pharmacist
  • Sugar Land, TX
  • NPI 1053063784
  NPD

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1003497538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12946 DAIRY ASHFORD RD STE 450",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784643",
            "telephone_number": "346-279-0497",
            "fax_number": "346-279-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12946 DAIRY ASHFORD RD STE 450",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784643",
            "telephone_number": "346-279-0497",
            "fax_number": "346-279-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAN-PHAM DIVERSIFIED HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "SEJAL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "281-203-7829"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDhope Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ayaz Shaikh, M.D.
• Shailaja Jamma MD PA
• Shakira Dhamotharan MD PLLC
• Nabeel Kamal Shalan, MD
• Shalom Health Care Services, Inc.
• Shan-Pham Diversified Holdings, Inc
• Kesavan Shan, MD, FACC
• Gregory L. Shannon, M.D.
• Meaghan Shannon
• Tanisha Shannon

• Mail Order Pharmacy in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Mail Order Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.