MEDICARE: DR. SAMUEL OFOSU MELFAH PHARMD.,PHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	45017	TX
2	1835P0200X	Pediatric Pharmacist	45017	TX
3	1835P1200X	Pharmacotherapy Pharmacist	45017	TX
4	1835P1300X	Psychiatric Pharmacist	45017	TX
5	1835P2201X	Ambulatory Care Pharmacist	45017	TX

General Provider Information

NPI Number	:	1043725443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL OFOSU MELFAH PHARMD.,PHC

Provider Business Mailing Address
First Line	:	3416 BLAZON GOLD WAY
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-0674
Country	:	US
Telephone Number	:	915-408-3475
Fax Number	:

Provider Business Practice Location Address
First Line	:	14476 HORIZON BLVD STE J
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-8579
Country	:	US
Telephone Number	:	915-852-8884
Fax Number	:	915-975-5893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2017
Last Update Date	:	12/13/2020

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