Shan-Pham Diversified Holdings, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHAN-PHAM DIVERSIFIED HOLDINGS, INC

Practice address

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

Phone

(281) 203-7829

NPI assigned

Apr 9, 2019

Organization subpart

No

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

Authorized official

Name

Sejal Shan, PHARM.D

Title

President

Phone

(281) 203-7829

Specialties & licenses 1

Addresses

Other names 1

• MEDhope Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

  • Mail Order Pharmacy
  • Sugar Land, TX
  • NPI 1003497538
  NPD tax ID

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1326501115",
    "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": "281-203-7829"
        },
        {
            "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": "281-203-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAN-PHAM DIVERSIFIED HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "SEJAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-203-7829",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDhope Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Victoria Shannon, DPT

• Community/Retail Pharmacy in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.