Provider Demographics
NPI:1154611747
Name:NEW HOPE PHARMACY LLC
Entity type:Organization
Organization Name:NEW HOPE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-919-2520
Mailing Address - Street 1:19940 CONANT ST STE D
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1494
Mailing Address - Country:US
Mailing Address - Phone:313-334-5203
Mailing Address - Fax:313-334-5206
Practice Address - Street 1:19940 CONANT ST STE D
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1494
Practice Address - Country:US
Practice Address - Phone:313-334-5203
Practice Address - Fax:313-334-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010095343336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129879OtherPK