Provider Demographics
NPI:1598905606
Name:GHAFFARIS MEDICAL PHARMACY, INC.
Entity Type:Organization
Organization Name:GHAFFARIS MEDICAL PHARMACY, INC.
Other - Org Name:COLONIAL HERITAGE PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:575-749-2915
Mailing Address - Street 1:1010 IVY AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4396
Mailing Address - Country:US
Mailing Address - Phone:505-934-8998
Mailing Address - Fax:505-836-7506
Practice Address - Street 1:1010 IVY AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4396
Practice Address - Country:US
Practice Address - Phone:505-934-8998
Practice Address - Fax:505-836-7506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GHAFFARIS MEDICAL PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health