Provider Demographics
NPI:1235268319
Name:NEW HOPE PHARMACY
Entity Type:Organization
Organization Name:NEW HOPE PHARMACY
Other - Org Name:NEW HOPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-9950
Mailing Address - Street 1:1920 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2714
Mailing Address - Country:US
Mailing Address - Phone:305-805-9950
Mailing Address - Fax:305-805-9949
Practice Address - Street 1:1920 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2714
Practice Address - Country:US
Practice Address - Phone:305-805-9950
Practice Address - Fax:305-805-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH226243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014650000Medicaid
2010232OtherPK
5973640001Medicare NSC