Provider Demographics
NPI:1699186809
Name:ST. HOPE FOUNDATION, INC.
Entity Type:Organization
Organization Name:ST. HOPE FOUNDATION, INC.
Other - Org Name:ST. HOPE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAM-COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-778-1300
Mailing Address - Street 1:6200 SAVOY DR STE 540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3338
Mailing Address - Country:US
Mailing Address - Phone:713-778-1300
Mailing Address - Fax:713-778-0827
Practice Address - Street 1:14815 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:832-532-0195
Practice Address - Fax:832-532-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145154OtherPK