# SAM HOUSTON STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University Health Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740491497
- **Authorized official:** ERICA BUMPURS (EXECUTIVE DIRECTOR HEALTH AND WELLB)
- **Authorized official phone:** (936) 294-1843

## Contact information

- **Practice address:** 1608 AVENUE J, HUNTSVILLE, TX 77340-5227
- **Practice address phone:** (936) 294-1803
- **Practice address fax:** (936) 294-3971
- **Mailing address:** 1608 AVENUE J, PO BOX 2358, HUNTSVILLE, TX 77340-5227
- **Mailing address phone:** (936) 294-1843
- **Mailing address fax:** (936) 294-3971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | 08007 | TX | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 10/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4513506 | NCPDP | — |
| 01 | — | 5930703 | NCPDP | — |