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General NPI Number Information
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NPI Number | 1306022249
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Entity Type | Organization
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Legal Business Name | GHAFFARI MEDICAL PHARMACY INC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 2929 N COORS NW 3RD FLOOR STE 310H
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City | ALBUQUERQUE
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State | NM
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Zip | 87120
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Country | US
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Telephone | 505-836-4801
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Fax | 505-836-4801
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Provider Business Mailing Address
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Address Line | 121 W 5TH ST
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City | CLOVIS
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State | NM
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Zip | 88101-7301
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Country | US
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Telephone | 505-749-2915
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Fax | 575-763-0062
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Authorized Official
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Title or Position | CEO
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Name | MISS LINDA ROSE GHAFFARI
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Credential |
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Telephone | 505-749-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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