# GHAFFARI MEDICAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** colonial heritage personal care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417150020
- **Authorized official:** MISS LINDA R GHAFFARI (OWNER)
- **Authorized official phone:** (505) 749-2915

## Contact information

- **Practice address:** 2929 N COORS NW 3RD FLOOR, STE 310H, ALBUQUERQUE, NM 87120
- **Practice address phone:** (505) 836-4801
- **Practice address fax:** (505) 836-4801
- **Mailing address:** 121 W 5TH ST, CLOVIS, NM 88101-7301
- **Mailing address phone:** (505) 762-3294
- **Mailing address fax:** (505) 763-0062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 63593729 | NM | Yes |

## Other

- **Enumeration date:** 06/09/2007
- **Last updated:** 12/18/2007